Brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism: radiological findings

Abstract

We report a case of a brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism. A 19-year-old woman presented with a 3-month history of pain in the left pubic region. The laboratory data showed elevated serum calcium and intact parathyroid hormone, confirming the diagnosis of primary hyperparathyroidism. Plain radiography and computed tomography (CT) showed an expansile lytic lesion of the superior ramus of the left pubis. The cortex was thinned. On magnetic resonance (MR) images, the lesion was solid and cystic. The solid area of the lesion showed heterogeneous low to intermediate signal intensity on T1-weighted images and heterogeneous low to high signal intensity on T2-weighted images. The cystic area showed several fluid-fluid levels on T2-weighted images. Dynamic contrast-enhanced MR images after administration of Gd-DTPA showed marked, early enhancement of the solid area of the lesion. A delayed image showed prolonged enhancement of the solid area and enhancement of the septa and walls of the cystic area. Histopathology of a biopsy specimen showed fibroblastic proliferation, abundant giant cells, and focal hemosiderin deposition, which supported the diagnosis of a brown tumor. After removing the parathyroid adenoma, the brown tumor regressed and became sclerotic on radiographs.

Multiple Brown Tumors in Primary Hyperparathyroidism Caused by an Adenoma Mimicking Metastatic Bone Disease with False Positive Results on Computed Tomography and Tc-99m Sestamibi Imaging: MR Findings

“…There is limited discussion of this MRI finding with brown tumors in the literature. Erem et al [11] and Takeshita et al [12] reported a brown bone tumor that on MRI was seen as an expansive mass lesion with heterogeneous hyperintensity on T2-WI in the sphenoid sinus, but without hemosiderin deposits. Accordingly, the present report is most likely the first to document MRI findings in the ribs.…”

Tumor Pardo Multifocal Como Manifestación Del Hiperparatiroidismo Primario Por Adenoma Paratiroideo Asociado a Carcinoma Papilar De Tiroides

“…Radiográficamente estos tumores se presentan como lesiones líticas uni o multiloculares bien definidas con escasa formación ósea 26,27 . En la Resonancia Magnética nuclear estas lesiones son hipointensas en la secuencia T1 y de densidad mixta en la secuencia T2, esto debido a la susceptibilidad magnética de la hemosiderina, la matriz osteoide y aire 27,28 .…”

Modern Synthesis and Thermoresponsivity of Polyphosphoesters

“…Although Zhao and coworkers reported that synthetic polyphosphoesters and polyphosphoesters are enzymatically degradable (Zhao et al, 2003), the process was not described in detail. The concentration of ALP for the degradation study was adjusted to 72.5 and 220 U/L, which is the concentration in healthy adults and children, respectively (Takeshita et al, 2004;Rafan et al, 2000). Figure 6 is an enzymatic degradation profile of G1A hydrogels by changing the concentration of ALP.…”