Spinal cord compression caused by a brown tumor at the cervicothoracic junction.
BACKGROUND
Brown tumors are classic benign skeletal manifestations of hyperparathyroidism, but the spine involvement is very rare. Spinal reconstruction in these patients is controversial because of the severe osteoporosis and impaired bone healing. Of the reported 12 cases of spinal brown tumors in the literature, only in 5 were reconstructions with bone graft used.


OBJECTIVE
To describe our management in a patient with brown tumor and also to review the previous published cases.


METHODS
Case report.


METHODS
A case of a brown tumor in the T1 vertebra of a 72-year-old male patient is described. He had a previous diagnosis of secondary hyperthyroidism caused by renal failure. First, posterior transpedicular open biopsy was performed for the diagnosis and also for the decompression of the root causing brachialgia. After the diagnosis of a brown tumor, the patient was reoperated through anterior approach for total tumor removal and reconstruction of the spine. An autolog 3-cortical iliac crest strut graft was used for fusion, and medical treatment of hyperparathyroidism was given immediately after the operation. Decompression of spinal canal and fusion of bone graft was shown by a computed tomography scan 1 year after the operation.


RESULTS
Complete resolution of the complaints of the patient and fusion of the graft were achieved.


CONCLUSIONS
The determination of a spinal tumor in a patient with renal failure and hyperparathyroidism should bring to mind the probability of a brown tumor. Although it is of a benign nature, it can cause severe neurologic deficit because of spinal compression. The recommended treatment modality is surgical resection of the tumor, spinal reconstruction, and aggressive treatment of hyperparathyroidism both with parathyroidectomy and medically.
Kaya
Ramazan Alper
RA
Clinic of Neurosurgery, Sişli Etfal Education and Research Hospital, 80220, Istanbul, Turkey. alpkaya67@yahoo.com
Cavuşoğlu
Halit
H
Tanik
Canan
C
Kahyaoğlu
Okan
O
Dilbaz
Suna
S
Tuncer
Cengiz
C
Aydin
Yunus
Y
D000368:Aged; D016025:Bone Transplantation; D019299:Decompression, Surgical; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D051437:Renal Insufficiency / Q000150:complications; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed