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Abstract
Brown tumor is a bone disease that arises in the setting of increased osteoclastic activity and fibroblastic proliferation in the involved bone. It is well recognized as serious complication of hyperparathyroidism. Brown tumor is uncommon, and brown tumor with secondary hyperparathyroidism resulting from chronic renal failure has rarely been reported. We recently experienced a case of a 28-year-old Korean woman with chronic renal failure caused by chronic glomerulonephritis, on hemodialysis for nine years. She has been hospitalized with left shoulder pain for two years. Image studies showed multiple cystic masses, and both suspicious marked thinning and partial destruction of the cortex on the head of the left humerus. Histopathologic analysis of the mass lesion showed a fibrotic capsule, hemosiderin pigmentation, and giant cell, all characteristic of brown tumor. A subtotal parathyroidectomy was done without surgery of the bony lesion (brown tumor), with successful results. We report this case with a brief review of the literature.
References
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Fig. 1.
Radiologic findings. Simple X-ray: Geographic expansile intramedullary osteolytic lesion from left proximal humerus head portion to metadiaphysis (A). Upper extremity CT axial view: Multiseptated cystic bone tumor in left humerus metadiaphysis area. Suspicious marked thinning and partial destruction in cortex. Edematous change in muscles and soft tissue area (B). MRI shoulder axial view: Multiseptated cystic bone tumor in left humerus metadiaphysis, prominent thinning in cortex, suspicious cortical destruction, edematous change in muscles and soft tissue area (C). Simple X-ray (5 months after surgery): Reduced expansile and osteolytic lesion of the left proximal humerus head portion (D). Upper extremity CT (5 months after surgery): Markedly reduced cystic portion of left humerus (E).
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