Pathologic causes of fractures compromised bone include neoplasms, infections, and certain inherited bone disorders. We described a 33-year-old man who complained of a painful mass over left lower limb for two months without any history of trauma. He had also suffered from nephrolithiasis several times over ten more years. This was a manifestation of parathyroid gland hyperplasia with multiple brown tumors and pathologic fracture. He underwent the operation of total parathyroidectomy plus open reduction and internal fi xation with an interlocking nail for pathologic fracture of the tibial shaft.
After six months, tibial fracture union was found from clinical and radiological evaluation. Besides, his blood sugar level returned to normal with oral medication, and multiple brown tumors over the whole body were resolved partially. This case illustrates the importance of fi nding out the primary lesion through some examinations and relevant investigations,with an emphasis on adequate management.