Secondary Hyperparathyroidism Presenting as a Brown Tumor: A Case Report and Review of the Literature

Abstract

Severe secondary hyperparathyroidism in advanced stages of chronic kidney disease (CKD) is associated with CKD-related mineral and bone disease (CKD-MBD). A 70-year-old woman was admitted at the Hospital for generalized bone pain and peripheral edema. Initial laboratory tests revealed normocytic anemia and severe renal dysfunction, and further tests evidenced severe secondary hyperparathyroidism. Full-body computerized tomography showed an osteolytic lesion in the right iliac wing. The iliac bone lesion was biopsied and histological examination was consistent with the diagnosis of a brown tumor of hyperparathyroidism.Brown tumors are a rare variant of osteitis fibrosa cystica that results from sustained high levels of parathyroid hormone in CKD. This case sheds light on rare complications that are experienced today in CKD. The clinical and biochemical setting, as well as the clinical suspicion, are essential to the diagnosis.

A Rare Manifestation of Secondary Hyperparathyroidism Due to Brown Tumors: A Case Report

“…These tumors appear more often in primary HP, although they are also seen in secondary and tertiary HP. 7,8 Clinically, a brown tumor presents as a slowly growing palpable mass and may cause bone pain or pathological fracture. Nonspecific general clinical features, such as weakness, polyuria, weight loss and recurrent nephrolithiasis, may also be associated with the accompanying HP.…”

Multiple Bone Cysts Caused by Hyperparathyroidism: A Case Report and Review of the Literature

“…CT images show irregular, multi-loculated osteolytic lesions, with "ground glass opacification" involving the cortex that may be interrupted; contrary to bone cysts, these lesions take the contrast media (12). Although cystic lesions were reported as one of the common types of the brown tumors, a large proportion of the lesions have been assessed with X-ray and/or CT (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). In contrast, MR images are useful to differentiate between solid and cystic lesions of brown tumors.…”