Cauda equina compression revealing brown tumor of the spine in a long-term hemodialysis patient.
Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.
Tarrass
Faissal
F
Department of Nephrology and Dialysis, Ibn Rochd University Hospital Center, 20100 Casablanca, Morocco. faissal76@hotmail.com
Ayad
Amal
A
Benjelloun
Meryem
M
Anabi
Abdelkabir
A
Ramdani
Benyounes
B
Benghanem
Mohamed Gharbi
MG
Zaid
Driss
D
D000328:Adult; D002420:Cauda Equina / Q000000981:diagnostic imaging*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications*; D019299:Decompression, Surgical; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed