Radiographic follow-up of a phalangeal brown tumor.
We report the 6-year radiographic follow-up of a phalangeal brown tumor in a patient with severe hyperparathyroidism secondary to chronic renal failure treated with hemodialysis. The phalangeal lesion increased in size during the first 3 years, until the patient finally accepted to undergo parathyroidectomy. The initial radiographic change was a small intracortical lytic area. Two years later, an expansile cystic lesion was visible in the phalanx, and computed tomography showed a cortical defect. Ossification of the lesion occurred over the 2.5 years following parathyroidectomy. The epidemiology, radiographic changes and post-treatment evolution of brown tumor in dialysed patients is reviewed. Surgical parathyroidectomy is the standard treatment for brown tumor complicating secondary hyperparathyroidism. The usefulness and limitations of treatment with vitamin D analogs, recently reported in a few case reports, are discussed.
Franco
M
M
Nephrology Department, Hĵpital Pasteur, 30, avenue de la Voie Romaine, 06202 Nice cedex 1, France. nephrologie@chu-nice.fr
Bendini
J C
JC
Albano
L
L
Barrillon
D
D
Cassuto
E
E
Bracco
J
J
D005385:Fingers / Q000000981:diagnostic imaging / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010002:Osteitis Fibrosa Cystica / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D016105:Parathyroidectomy; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed