Brown tumour as a complication of secondary hyperparathyroidism in severe long-lasting vitamin D deficiency rickets

Bereket, Abdullah; Casur, Y.; Fırat, Penpe Gül; Yordam, Nurşen

doi:10.1007/pl00013807

Cited by 37 publications

(21 citation statements)

References 8 publications

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“…Vitamin D deficiency rickets is among the most common causes of secondary hyperparathyroidism in developing countries. To our knowledge, only two reports of a patient with a brown tumor secondary to hyperparathyroidism due to dietary vitamin D deficiency and inadequate sunlight exposure, have been described [8,9]. Other possible causes of lytic bone lesions such as metastatic tumors, fibroma and reticuloendothelioma should be excluded.…”

Section: Discussionmentioning

confidence: 97%

A Brown Tumor after Biliopancreatic Diversion for Severe Obesity

Benhalima¹,

Mertens²,

Annick³

et al. 2009

Endocr J

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Abstract. A case of a brown tumor due to iatrogenic malabsorption following biliopancreatic diversion (BPD) is presented. A 52 year old women with a history of BPD 2 years before was referred to orthopedic surgery because of a painful lytic lesion of the left ankle. A bone biopsy revealed a giant cell tumor compatible with the diagnosis of a brown tumor. Subsequent metabolic evaluation showed severe 25-hydroxy vitamin D deficiency and secondary hyperparathyroidism (PTH 60 ng/L or twice the upper normal limit). Bone mineral density was decreased at the femoral neck (0.50 g/cm 2 ; T score of -3.92 or 66% of the expected value) and lumbar spine (T score of -1.75 or 93% of the expected value). A brown tumor can be the presenting symptom of iatrogenic malabsorption due to BPD. This case illustrates the severity of potential bone complications after BPD and the necessity of lifelong surveillance and vitamin supplements after BPD. We report an unusual case of a brown tumor, due to severe vitamin D deficiency and secondary hyperparathyroidism after biliopancreatic diversion operation (BPD) for severe obesity. Methods Tissue processing and histologyThe biopsy and currettage specimens were fixed in 6% formalin. After decalcification, the specimens were both entirely processed for paraffin embedding and staining with hematoxylin and eosin (H and E) for histopathological evaluation. No immunohistochemistry was performed. Biochemically measurementsCalcium was measured spectrophometrically (0-cresolphtalein in compexon method) and alkaline phosphatase activity was determined according to the

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Section: Discussionmentioning

confidence: 97%

A Brown Tumor after Biliopancreatic Diversion for Severe Obesity

Benhalima¹,

Mertens²,

Annick³

et al. 2009

Endocr J

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“…Concurrent changes that suggest brown tumours such as osteopaenia, a ‘salt-and-pepper’ bone appearance, subperiosteal bone resorption and disappearance of the lamina dura around the roots of the teeth, may help differentiate it from other entities 28–30. Tomographic imaging shows an osseous mass, with no cortical disruption, no periosteal reaction or inflammatory signs, a heterogeneous centre and areas that suggest cysts.…”

Section: Discussionmentioning

confidence: 99%

A bilaterally recurring exophytic mass on the lower jaw

Thomas

Nair²,

Hegde

et al. 2011

Case Reports

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“…[1][2][3] Although these tumors are present in primary hyperparathyroidism, cases associated with chronic renal failure (CRF) are being reported with increasing frequency. Brown tumors in CRF patients are an extreme form of osteodystrophy.…”

Section: Introductionmentioning

confidence: 99%

“…Brown tumors in CRF patients are an extreme form of osteodystrophy. [2][3][4] These tumors are more common in long bones, ribs and the pelvis, but may occur in any bone, such as the jaw, albeit rarely in this case.…”

Section: Introductionmentioning

confidence: 99%