Multiple brown tumors caused by primary hyperparathyroidism as a differential diagnosis to multiple osteolytic bone metastases: A case report

Zeina Hadad*, Louise Tjelum, Pia Eiken, Waldemar Trolle, Ilia Haupter, Pia Afzelius

*Corresponding author af dette arbejde

Abstrakt

Brown tumors are benign osteolytic lesions, which usually respect the bone cortex. Since these lesions may resemble bone metastases, it is important to consider them as a potential differential diagnosis. They occur as a result of increased parathyroid hormone (PTH) se-cretion mainly due to primary or secondary hyperparathyroidism. We present a case of multiple osteolytic lesions incidentally found on X-ray examinations in a patient, who had a radius fracture after a low-energy trauma. Due to the suspicion of multiple bone metastases, one of them mimicking sequels after a pathological fracture in the ulna, the patient had a positron emission tomography/computed to-mography (PET/CT) and a magnetic resonance imaging (MRI) scan performed supporting the existence of pervasive bone lesions without suggesting a primary malignancy. The blood samples showed highly elevated ionized calcium and PTH levels. Therefore, an ultrasound examination and parathyroid scintigraphy were performed, reveal-ing a hyperfunctioning parathyroid adenoma. After removal of the adenoma, the PTH level normalised and the bone changes regressed without surgical intervention.

OriginalsprogEngelsk
TidsskriftJournal of Endocrinology and Metabolism
Vol/bind10
Udgave nummer3-4
Sider (fra-til)94-100
Antal sider7
ISSN1923-2861
DOI
StatusUdgivet - 1 aug. 2020

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