| Lu Jiang,Yi Huang,Yazhou Han. Brown tumor of the femur and ulna in a woman with hyperparathyroidism. Oncol Transl Med, 2019, 5: 98-101. |
| Brown tumor of the femur and ulna in a woman with hyperparathyroidism |
| Received:September 15, 2018 Revised:January 15, 2019 |
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| KeyWord:brown tumor; hyperparathyroidism (HPT); fibrocystic osteitis; pathological fractures |
| Author Name | Affiliation | Postcode | | Lu Jiang | Dalian Municipal Central Hospital，Dalian Medical University | 116033 | | Yi Huang | Dalian Municipal Central Hospital | | | Yazhou Han | Dalian Municipal Central Hospital | 116033 |
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| Abstract: |
| Objective: A typical brown tumor caused by hyperparathyroidism (HPT) is rare. In this report, we describe
our pathological findings along with a review of the literature to enhance understanding of the disease and
prevent misdiagnosis, as well as to provide evidence for treatment and prognosis.
Methods: We present a case of brown tumor of the left proximal femur and pelvis in a 57-year-old woman
who was admitted to our hospital (Dalian Municipal Central Hospital, Dalian, China). Pelvic computed
tomography (CT) showed cystic expansile lesions in the left proximal femur and pelvis. Lung and abdominal
CT also revealed multiple lytic lesions in the ribs and lumbar spine. X-ray of the left ulna and radius showed
that the middle of the left ulna had a fracture caused by a brown tumor. A bone biopsy from the left proximal
femur showed focal distribution of giant cells, with hemorrhage and fibrin hyperplasia.
Results: The patient underwent internal fixation of the left intertrochanteric fracture, and postoperative
bone biopsy showed focal distribution of giant cells with hemorrhage and fibrin hyperplasia. The patient
had a parathyroidectomy 5 months after discharge. Two weeks later, the patient developed a fracture in the
right femoral neck and pain in the left forearm. X-ray of the left ulna and radius showed that the middle of
the left ulna was affected by a pathological fracture caused by a brown tumor. The patient was debilitated
and declined surgical treatment. The patient and her family chose discharge.
Conclusion: Brown tumor of bone, also called osteitis fibrosa cystica, is a rare non-neoplastic lesion that
reflects abnormal bone metabolism in patients with HPT. However, with fine needle aspiration cytology in
combination with biochemical tests, a correct diagnosis can be reached. The increase in osteoclast activity
leads to decalcification and dissolution of bone, and formation of a cystic bone defect with hyperplastic
fibrous tissue. This eventually becomes a brown tumor, with deformed and bleeding fibrous tissue. The
patient had a typical brown tumor, as well as osteoporosis, anemia, and pathological fractures. |
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