| 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. |
| 一例女性甲状旁腺功能亢进股骨和尺骨棕色瘤 |
| Brown tumor of the femur and ulna in a woman with hyperparathyroidism |
| Received:September 15, 2018 Revised:January 15, 2019 |
| DOI：10.1007/s10330-018-0301-1 |
| 中文关键词: 棕色瘤；甲状旁腺功能亢进；纤维囊性骨炎；病理性骨折 |
| 英文关键词: brown tumor; hyperparathyroidism (HPT); fibrocystic osteitis; pathological fractures |
| 基金项目: |
| 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 |
|
| Hits: 7231 |
| Download times: 8607 |
| 中文摘要: |
| 目的：甲状旁腺功能亢进（HPT）引起的典型棕色瘤是罕见的。在本报道中，我们报道了我们的病理结果及回顾相关文献改善我们对棕色瘤的认识和误诊以及对棕色瘤的诊断和治疗。
方法：我们报道了1例我们医院1个57岁左侧股骨近端和骨盆的棕色瘤患者。CT显示：在股骨近端和骨盆有囊性扩张病灶。左股骨近端骨活检显示：巨细胞灶状分布，伴有纤维增生和出血。
结果：病人经历了左股骨粗隆下内固定手术，术后骨活检显示：巨细胞灶状分布，伴有纤维增生和出血。病人出院后5个月行甲状旁腺切除术，术后两周患者二次发生了右侧股骨颈骨折再次入院，而病人目前身体状况太差不能耐受手术，最后选择出院。
讨论：棕色瘤也叫纤维囊性骨炎，是由于HPT引起的异常骨代谢而导致的一种罕见的非肿瘤性骨损害。细针穿刺细胞学检查（FNAC）结合生化检查可以明确诊断。破骨细胞活动增加可以导致骨脱钙和骨溶解，伴有纤维组织增生和骨囊性缺损形成。病人有典型的棕色瘤，骨质疏松，贫血和病理性骨折。 |
| 英文摘要: |
| 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. |
|
View Full Text
Download reader HTML全文 |
| Close |