Brown tumor of the sacral spine in a patient with low-back pain

Abstract

We present a case of a 44-year-old woman with an unusual location of a brown tumor in the sacral vertebrae due to parathyroid adenoma. She was admitted to our clinic with the complaint of low-back pain and was later diagnosed to have a brown tumor. The patient underwent surgery and partial sacrectomy and iliac wing resection was performed in Orthopedic Surgery Department. Subsequently the patient underwent parathyroid adenoma excision in General Surgery Department. On her control examination at postoperative 3 months, she had no pain and was able to perform daily activities without any problem. We believe it is an interesting clinical case both because it shows a very rare localization of brown tumor and points out the importance of employing a wide clinical scope in the differential diagnosis of back pain.

Brown tumor as an unusual but preventable cause of spinal cord compression: Case report and review of the literature

“…If the spinal alignment is confirmed radiologically and/or intraoperatively, the patient can be subjected to orthosis without spinal fixation. [1046]…”

A Rare Cause of Primary Hyperparathyroidism Presented with Giant Adenoma, Multiple Brown Tumors And End Stage Renal Failure

“…Brown tumors commonly occur in the mandible, maxillary sinus, sternum, pelvis and femur. PHPT is known to be a more frequent etiologic factor than the SHPT in the development of brown [8,9].…”

A haemodialysis patient with back pain: brown tumour as a cause of spinal cord compression under cinacalcet therapy

“…If left untreated, hyperparathyroidism will worsen and eventually lead to high-turnover bone disease, characterized by increased osteoblastic and osteoclastic activity, and fibroblastic proliferation, ultimately leading to the formation of a brown tumour, an extreme form of osteitis fibrosa cystica [1–5]. Brown tumours are known to only occur in the setting of primary or secondary hyperparathyroidism and are nowadays rare, which is considered to be the result of better diagnosis and more effective treatment of hyperparathyroidism [3]. The Kidney Disease: Improving Global Outcomes guideline for CKD 5D suggests maintaining iPTH levels in the range of two to nine times the upper normal limit [1].…”

“…However, the clinical history of renal failure and severe secondary hyperparathyroidism combined with increased alkaline phosphatase raises suspicion for a brown tumour. When diagnostic uncertainty persists, histological investigation of a lesion is recommended [3,8]. …”