Brown tumor complicating end-stage kidney disease

Wiederkehr, Michael R.

doi:10.5414/cncs110195

Cited by 3 publications

(5 citation statements)

References 30 publications

(5 reference statements)

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“…ESRD is one of the most common causes of sHPTH and can lead to the so-called "renal osteodystrophy." It includes several manifestations such as osteitis fibrosa cystica, osteomalacia, osteosclerosis [4,6]. Osteitis fibrosa cystica can present as lytic or sclerotic bone lesions secondary to severe bone resorption due to persistently high levels of PTH [4].…”

Section: Discussionmentioning

confidence: 99%

“…In certain cases, they can be recurrent [8]. The first case of a brown tumor of the spine secondary to primary hyperparathyroidism (pHPTH) was published in 1968 [6].…”

Section: Discussionmentioning

confidence: 99%

“…The final diagnosis is made by tissue examination [4], which commonly reveals increased osteoclastic activity, multinucleated giant cells, fibroblast proliferation, and hemosiderin deposition [3,4]. The loose connective tissue is replaced by cortical and trabecular bone [6].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Medical management of the brown tumor consists of treating the sHPTH with phosphate binders, vitamin D analogs, and calcimimetics, and limiting dietary phosphorus intake [6]. If medical treatment fails, then the patient should be referred for parathyroidectomy [6]. Bisphosphonate use was reported in some cases of spinal implication before the surgical intervention to potentially suppress an increase in the tumor size post-parathyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Brown Tumor With Spine Involvement at Multiple Levels in a Hemodialysis Patient

Ghernautan

Idrees

Nassar

et al. 2021

Cureus

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Brown tumor of the bone or osteitis fibrosa cystica is a rare manifestation of hyperparathyroidism, most seen nowadays in association with secondary and tertiary hyperparathyroidism. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are the major culprits of secondary hyperparathyroidism (sHPTH). CKD is known to cause phosphate retention and a decrease in 1,25-dihydroxyvitamin D and ionized calcium levels, which in turn trigger the PTH secretion. Brown tumor can affect the jawbones, femur, sternum, ribs, and rarely the spine. We present the case of a 60-year-old male with ESRD on hemodialysis who was found to have lytic bone lesions in the thoracic and lumbar spine. Initially, malignancy was suspected. Blood work revealed markedly elevated PTH at 3,563 pg/mL, hypocalcemia, and hyperphosphatemia. Biopsy of the L5-S1 lesion was consistent with reactive changes due to sHPTH. Once a diagnosis of the brown tumor was confirmed, the patient was started on cinacalcet and was referred for parathyroidectomy.

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Section: Discussionmentioning

confidence: 99%

“…In certain cases, they can be recurrent [8]. The first case of a brown tumor of the spine secondary to primary hyperparathyroidism (pHPTH) was published in 1968 [6].…”

Section: Discussionmentioning

confidence: 99%