TY - JOUR
T1 - Multiple brown tumors caused by primary hyperparathyroidism as a differential diagnosis to multiple osteolytic bone metastases
T2 - A case report
AU - Hadad, Zeina
AU - Tjelum, Louise
AU - Eiken, Pia
AU - Trolle, Waldemar
AU - Haupter, Ilia
AU - Afzelius, Pia
PY - 2020/8/1
Y1 - 2020/8/1
N2 - 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.
AB - 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.
KW - Brown tumors
KW - Metastasis
KW - Osteolytic bone lesions
KW - Parathyroid adenoma
KW - Primary hyperparathyroidism
UR - http://www.scopus.com/inward/record.url?scp=85089831612&partnerID=8YFLogxK
UR - https://www.jofem.org/index.php/jofem/article/view/637/284284467
U2 - 10.14740/jem.v10i3-4.637
DO - 10.14740/jem.v10i3-4.637
M3 - Journal article
AN - SCOPUS:85089831612
VL - 10
SP - 94
EP - 100
JO - Indian Journal of Endocrinology and Metabolism
JF - Indian Journal of Endocrinology and Metabolism
SN - 2230-8210
IS - 3-4
ER -