Multiple bone brown tumor secondary to primary hyperparathyroidism: a case report and literature review

Xu, Weihua; Qu, Yanqing; Shi, Wen; Ma, Ben; Jiang, Hongyi; Wang, Yu; Qu, Ning; Zhu, Yixin

doi:10.21037/gs.2019.11.14

Cited by 17 publications

(38 citation statements)

References 29 publications

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“…OFC is uncommon in clinical practice, and its clinical symptoms and imaging findings are easily confused with malignant bone tumors. However, brown tumors are difficult to diagnose, leading to delayed treatment (12). Histology cannot guarantee a certain diagnosis, as other lesions, such as giant cell tumor, giant cell granuloma, aneurysmal bone cyst, and some variants of osteosarcomas show similar macroscopical and microscopical features because all these conditions contain giant-cell lesions (2,13,14).…”

Section: Discussionmentioning

confidence: 99%

“…Multiple skeletal lesions (brown tumors) represent a rare clinical manifestation of prolonged hyperparathyroidism and are reported in approximately 2%-5% of patients with primary hyperparathyroidism (12,16). We therefore performed a literature search on the characteristics of bone brown tumors caused by secondary to primary hyperparathyroidism.…”

Section: Discussionmentioning

confidence: 99%

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Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism – A Case Report and Systematic Review of the Current Literature

et al. 2021

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Background/Aim: Pathological fractures are rare, suspicious and in some cases mentioned as the first sign of a malignant tumor. We present an uncommon case with a pathological fracture of the tibia diaphysis as the first sign of severe hyperparathyroidism. Case Report: We report the case of a female patient who was referred to the emergency department with a history of progressively worsening pain in the lower left leg and an inability to fully bear weight. No history of trauma or any other injury was reported. An x-ray revealed an extensive osteolytic lesion in the tibial shaft with cortical bone destruction. Conclusion: Our case, together with very few cases described in the current literature, emphasizes that in the presence of hypercalcemia and lytic lesions primary hyperparathyroidism should always be considered as a differential diagnosis. Lytic bone lesions can lead to pathological fractures and severe impairment of quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism – A Case Report and Systematic Review of the Current Literature

et al. 2021

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“…An increase of blood parathyroid hormone concentration activates the osteoclast. Due to the rapid bone loss, haemorrhage, granulation tissue and fibrous tissue replace the bone marrow; the brownish due to haemosiderin deposition, that are referred as brown tumor [5] , [6] , [7] , [8] . It can cause pain and fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Some patients present with symptoms involving the urinary system [6] . Ultrasound and CT scans of abdomen should be done to identify urinary stone.…”

Section: Discussionmentioning

confidence: 99%

The pathology femoral peritrochanteric fracture with multiple brown tumor as a first sign of parathyroid cancer – A case report

Nguyen

2021

International Journal of Surgery Case Reports

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Introduction and importance The parathyroid cancer is sometime only diagnosed after a pathological fracture has occurred, and pathology fracture is often misdiagnosed as a malignancy tumor. The treatment for pathology fracture and multiple bone lesions is not defined. Case presentation We report a 41-year-old case of parathyroid carcinoma in which pathological femoral fracture and brown tumors are the first clinical signs of the disease and that masqueraded as a malignancy tumor. The treatment for the patient was parathyroidectomy and then surgical treatment of the right femur with a locking plate osteosynthesis. Four months post-operative, the patient reported no pain and became capable of walking without a crutch. X-rays showed full bone union at fracture site of right femur, and brown tumors regression seen to be taking place in the upper limb, lower limbs and pelvis. Clinical discussion A brown tumor was diagnosed by a high concentration of blood parathyroid hormone and serum calcium. Despite the lack of clinical guidelines, most authors agreed that parathyroidectomy was the first choice of treatment then orthopaedic treatment. The principles of osteosynthesis of fracture were based on stable osteosynthesis. It was reported that osteolytic lesions caused by brown tumor were recovered when hyperparathyroidism had been treated. Conclusion Brown tumor needs to be considered in the differential diagnosis when there are osteolytic lesions and high serum calcium. It is advisable to have a parathyroidectomy and then orthopaedic treatment. Brown tumor with Mirels' score less than 7 scores should be applied a conservative treatment.

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“… 22 , 23 , 25 Some patients mainly present with skeletal system diseases, which is the most common presentation in the clinical setting. These patients often have obvious symptoms, such as bone pain, osteoporosis, and pathological fracture; they may also develop brown tumors, 26 osteitis fibrosa cystica, 27 and other specific clinical manifestations. Some patients mainly present with symptoms involving the urinary system (e.g., kidney calculi, ureteral calculi, azotemia, or renal insufficiency).…”

Section: Discussionmentioning

confidence: 99%

Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

Wang

Liu

2020

J Int Med Res

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Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

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Multiple bone brown tumor secondary to primary hyperparathyroidism: a case report and literature review

Cited by 17 publications

References 29 publications

Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism – A Case Report and Systematic Review of the Current Literature

Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism – A Case Report and Systematic Review of the Current Literature

The pathology femoral peritrochanteric fracture with multiple brown tumor as a first sign of parathyroid cancer – A case report

Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

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