Brown tumor of the pelvis

Glushko, Tetiana; Banjar, Shorooq; Nahal, Ayoub; Colmegna, Inés

doi:10.3949/ccjm.82a.14146

Cited by 8 publications

(10 citation statements)

References 4 publications

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“…The incidence of brown tumors are quite rare, occurring in approximately 2% of adult patients suffering from any form of hyperparathyroidism and commonly affect the mandible, clavicle, ribs, and pelvis. [9][10][11]. While most presentations of hyperparathyroidism are asymptomatic in occidental countries, skeletal manifestations are seen more commonly in countries such as India, Iran, Saudi Arabia and Thailand.…”

Section: Discussionmentioning

confidence: 99%

Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

et al. 2020

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Background Primary hyperparathyroidism may present in a myriad of manners, varying from an incidental asymptomatic biochemical finding to gastrointestinal, psychiatric, renal, and bone manifestations. While hyperparathyroidism remains a rare diagnosis in the pediatric population, the initial approach to diagnosis and management of hypercalcemia in children is imperative for the general pediatrician. Herein, we describe an adolescent who presented with a lytic bone lesion and severe, symptomatic hypercalcemia due to primary hyperparathyroidism. Case presentation A 14-year-old male presented with vomiting, constipation, abdominal pain, and lethargy. He had an elevated total corrected calcium of 4.3 mmol/L. He was found to have a large pelvic lytic tumor consistent with a brown tumor due to primary hyperparathyroidism. He received pharmacologic therapy for stabilization of his hypercalcemia, including intravenous saline, intravenous bisphosphonates, and calcitonin. He subsequently received definitive therapy via parathyroidectomy and his post-operative course was complicated by hungry bone syndrome. Long-term follow-up has found full resolution of the lytic lesion and restored calcium homeostasis. Conclusions We present this case to highlight the possible presentations of hypercalcemia and hyperparathyroidism that are essential for a general pediatrician to recognize to ensure prompt diagnosis and management. Evaluation for hypercalcemia should be considered in patients with suggestive symptoms and physical exam findings. To our knowledge, this patient represents the first reported pediatric case of a pelvic brown tumor in an adolescent. While the multi-systemic complications of hyperparathyroidism may be quite severe, swift and appropriate management may mitigate these clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

et al. 2020

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“…From a treatment standpoint, parathyroidectomy has been shown to result in complete brown tumor regression [29,30]. While parathyroidectomy is considered first line for treatment of OFC, surgical management of osseous lesions is debated and may be considered in certain patients [31]. ese situations occur in the setting of misdiagnosis, delays in treatment, or lack of biochemical screening, which are more commonly seen in PHPT patient populations of developing countries [31].…”

Section: Focal Lytic Lesionsmentioning

confidence: 99%

“…While parathyroidectomy is considered first line for treatment of OFC, surgical management of osseous lesions is debated and may be considered in certain patients [31]. ese situations occur in the setting of misdiagnosis, delays in treatment, or lack of biochemical screening, which are more commonly seen in PHPT patient populations of developing countries [31]. Examples of lesions that may require surgery include those that fail to regress or have extensive brown tumor involvement of surrounding structures, for which local bone surgical intervention may be warranted [16,29,31].…”

Section: Focal Lytic Lesionsmentioning

confidence: 99%

“…ese situations occur in the setting of misdiagnosis, delays in treatment, or lack of biochemical screening, which are more commonly seen in PHPT patient populations of developing countries [31]. Examples of lesions that may require surgery include those that fail to regress or have extensive brown tumor involvement of surrounding structures, for which local bone surgical intervention may be warranted [16,29,31]. Other cases entail large, aggressive brown tumors associated with severe pain, delayed treatment, pathological fractures leading to disability, or recurrence after parathyroidectomy [31].…”

Section: Focal Lytic Lesionsmentioning

confidence: 99%

“…In PHPT, mechanistically, there is resorption of secondary trabeculae (which corresponds to interlinking non-weight-bearing trabeculae) and accentuation of primary trabeculae (weight-bearing trabeculae) and overall decreased bone density due to the increased osteoclastic activity and vascularized fibrous tissue seen in PHPT. Generalized and asymmetric osteopenia is the most common skeletal finding in modern-day PHPT [7,16,31]. Recent studies cite the prevalence of osteoporosis in PHPT ranging from 39 to 62.9% [7].…”

Section: Osteopenia Osteopenia Is Defined By the Worldmentioning

confidence: 99%

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Osseous Manifestations of Primary Hyperparathyroidism: Imaging Findings

Bennett

Suliburk

Morón

2020

International Journal of Endocrinology

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Primary hyperparathyroidism is a systemic endocrine disease that has significant effects on bone remodeling through the action of parathyroid hormone on the musculoskeletal system. ese findings are important as they can aid in distinguishing primary hyperparathyroidism from other forms of metabolic bone diseases and inform physicians regarding disease severity and complications. is pictorial essay compiles bone-imaging features with the aim of improving the diagnosis of skeletal involvement of primary hyperthyroidism.

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Osteitis fibrosa cystica

Rad

Deluxe

SpringerReference

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Brown tumor of the pelvis

Cited by 8 publications

References 4 publications

Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

Osseous Manifestations of Primary Hyperparathyroidism: Imaging Findings

Osteitis fibrosa cystica

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