Multiple brown tumors in primary hyperparathyroidism

Osteolytic Lesions (Brown Tumors) of Primary Hyperparathyroidism: A Report of Two Cases

“…The pathogenesis of brown tumors involves excessive osteoclastic activity resulting in bone resorption, subsequently replaced by fibrotic tissue and giant cells. The predilection sites for brown tumors commonly include the clavicle, jaw, ribs, and pelvis, with less frequent occurrences noted in the cranial region [7]. Notably, in our cases, the lumbar spine and tibia were the affected sites.…”

“…The clinical presentations of these neoplasms exhibit variability and lack specificity, encompassing symptoms such as weakness, weight loss, bone pain, or pathological fractures, occasionally manifesting as progressive bone enlargement or urinary lithiasis [7]. Our patients reported bone pain as the primary complaint.…”

“…However, while thyroid uptake diminishes in later images, parathyroid uptake persists and intensifies over approximately two hours. This persistent and heightened uptake in parathyroid adenomas distinguishes them from the surrounding thyroid tissue [7].…”

“…From a biological perspective, the diagnosis of PHPT hinges upon the concurrent presence of hypercalcemia and hyperparathyroidism, coupled with hypophosphatemia and hypercalciuria [7]. In cases of suspected or confirmed hyperparathyroidism, cervical ultrasound and technetium 99m sestamibi scintigraphy are frequently used radiological modalities.…”

“…However, distinguishing between a brown tumor and a giant cell tumor through histology can be challenging. Hence, it is crucial to consider the presence of hypercalcemia and hyperparathyroidism for an accurate diagnosis [7].…”