[Brown tumor as an exceptional origin of lumbocruralgia with favourable outcome]

Abstract

Introduction: We report a case of a particular lumbar and radicular pain revealing primary hyperparathyroidism and discuss its characteristics through a literature review.

Case report: A 55-year-old woman was hospitalized for a nerve root pain associated with recent weight loss with normal physical examination. Biology showed no evidence for acute phase response and normal kidney and liver functions. However, hypercalcemia and hypophosphatemia were evidenced. Radiographs of the lumbar spine showed a lytic lesion occupying the body of L4. A lumbar spine CT scan confirmed the presence of a compressive nerve root brown tumor. High level of PTH and parathyroid mass raised the possibility of the diagnosis of primary hyperparathyroidism. After parathyroidectomy all signs of hyperparathyroidism resolved with complete disappearance of spinal brown tumors in a two year follow-up CT scan.

Conclusion: Although uncommon, brown tumor should be a diagnosis to consider in their presence of a spinal tumor. The improvement after conservative treatment could be dramatic.

Keywords: Brown tumor; Hyperparathyroidism; Hyperparathyroïdie; Spine neoplasm; Tumeur brune; Tumeur rachidienne.