Journal List > J Korean Endocr Soc > v.23(5) > 1003459

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Park, Kang, Kim, Kim, Baek, Kim, Cho, Lee, Ko, and Rhee: Brown Tumor of the Ulna and Radius: An Unusual Presentation of Primary Hyperparathyroidism
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2008; 23(5): 347-351.

Published online: 31 October 2008

DOI: https://doi.org/10.3803/jkes.2008.23.5.347

Brown Tumor of the Ulna and Radius: An Unusual Presentation of Primary Hyperparathyroidism

Hyun Park, Gun Hi Kang, Seung Gu Kim, Jun Jae Kim, Na Na Baek, Dae Myung Kim, Sung Woo Cho, Woo Je Lee, Kyung Soo Ko, Byoung Doo Rhee

Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Korea.

Received 31 July 2008       Accepted 12 September 2008

Copyright © 2008 Korean Endocrine Society

Abstract

Brown tumors are erosive bony lesions caused by chronic excessive secretion of parathyroid hormone. Since the introduction of routine calcium measurement, the diagnosis of hyperparathyroidism has usually been made in asymptomatic patients and as a result, brown tumors are rarely observed as an initial manifestation of hyperparathyroidism.
We report the case of a 70-year-old woman who presented with right wrist pain. A roentgenogram showed erosive bone tumors of the ulna and radius, which were mistaken for primary or metastatic bone tumors. Extensive workups were performed to determine the cause(s); however, these lesions were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case illustrates the diagnostic pitfall in patients who present with skeletal manifestations of hyperparathyroidism and the need for vigilance and a high level of suspicion by physicians.

Keywords: brown tumor, forearm, hyperparathyroidism

Figures and Tables

Fig. 1
A. Forearm roentgenogram shows osteolytic changes (arrows) on bilateral ulna and radius. B. Forearm roentgenogram taken at 8 months after parathyroid operation shows no significant interval change of osteolytic lesions (arrows) on right ulna and radius.
jkes-23-347-g001
Fig. 2
99mTc-sestamibi parathyroid scan shows no focal parathyroid uptake on 120 minutes delayed image.
jkes-23-347-g002

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