Primary hyperparathyroidism (PHPT) is a disease commonly seen in postmenopausal women. We report two cases of pathological fractures following trivial injuries in two different age groups; the middle and teen age group presented as PHPT due to parathyroid adenoma. PHPT usually presents with symptomatic hypercalcemia and target organ damage. Biochemical manifestations in both cases are similar i.e. hypercalcemia, elevated serum intact parathyroid hormone (iPTH), and mass in the parathyroid gland. Histopathological examination is consistent with parathyroid adenoma. We highlighted these two cases due to long delay before the PHPT diagnosisisconfirmedbecause of various investigations commenced in these patients to rule out other diagnoses. Bangladesh Journal of Medical Science Vol. 22 No. 01 January’23 Page : 234-238

A young adult patient with 46XX congenital adrenal hyperplasia (CAH) presented with recurrent painful haematuria. CAH was diagnosed at birth following ambiguous genitalia. Hormonal treatment was started, female gender was assigned and feminising genitoplasty was planned, however the patient was lost to follow-up. Gender dysphoria started to occur during childhood which prompted the family to raise the patient as a boy. He eventually identified himself as a male. Examination revealed a male phenotype with severely virilised genitalia. Imaging studies confirmed the presence of uterus with low confluent urogenital sinus. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and the troublesome symptoms were cured.