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Case Reports
. 2012 Nov;16(6):1040-2.
doi: 10.4103/2230-8210.103037.

Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy

Ekram Ullah  1 , Mehtab Ahmad, Syed Asmat Ali, Navneet Redhu
Affiliations
Case Reports

Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy

Ekram Ullah et al. Indian J Endocrinol Metab. 2012 Nov.

Abstract

Primary hyperparathyroidism is a disease characterized by excessive secretion of parathormone. During the course of this disease, bone loss occurs, particularly depending on resorption of the skeletal system. One of the complications of primary hyperparathyroidism is fibrotic, cystic bony changes which is called Brown tumor. Skeletal manifestations in the form of Brown tumors are rare and according to literature occur in less than 2% of patients suffering from any form of hyperparathyroidism. Such rare and multiple benign lesions may simulate a malignant neoplasm and pose a real challenge for the clinician in its differential diagnosis. We present a case of a 23-year-old Indian woman who was evaluated for multiple lytic expansile lesions with a strong suspicion of malignancy and fibrous dysplasia but turned out to be a case of primary hyperparathyroidism.

Keywords: Brown tumors; endocrine system; expansile lesions; primary hyperparathyroidism.

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Conflict of interest statement

Conflict of Interest: No

Figures

Figure 1
Figure 1
(a) Radiograph left shoulder AP view shows geographic lytic expansile lesion with pathological fracture in metadiaphyseal region of left humerus with similar lesion in the fifth posterior rib in the left side of the chest with sparing of epiphysis. (b) Radiograph of both hands AP view shows lytic expansile lesion with no evidence of calcification in the third metacarpal of the right hand and the fifth metacarpal of the left hand
Figure 2
Figure 2
(a) Radiograph of pelvis with both hips. AP view shows multiple lytic expansile lesions with ground glass appearance in whole pelvis with fixation device in situ for pathological fracture in diaphysis of right femur. (b) Radiograph of right knee anterioposterior view and lateral view shows lytic expansile lesions in the metadiaphyseal region of lower third right femur and upper third of right tibia
Figure 3
Figure 3
Ultrasound neck shows well-defined homogenous hypoechoeic solid mass lesion in relation to the posterior aspect of the inferior pole of the left lobe of thyroid
See this image and copyright information in PMC

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