Missed brown tumors in a young adult with decreased bone density.
Brown tumors, a benign osteolytic process, are most commonly caused by hyperparathyroidism. Multiple bone involvement is relatively rare. There are many similarities in the radiologic and histological features of brown tumors and giant cell tumors (GCTs) of bone. Differentiation between the two lesions is dependent upon evaluation of serum biochemistry including serum calcium, phosphorous, and intact parathyroid hormone (I-PTH) levels. Herein, the case of a 32-year-old man with multiple osteolytic lesions of the left tibia and fibula as well as the fourth metacarpal bone of the left hand, previously misdiagnosed with multiple GCTs, is presented. Based on the radiographic findings and biochemistry results in a young adult patient, brown tumor was suspected and subsequently definitively diagnosed.
Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Hao-Lun
HL
Kao
Wei-Chou
WC
Chang
Chian-Her
CH
Lee
Herng-Sheng
HS
Lee
Guo-Shu
GS
Huang
D000328:Adult; D001851:Bone Diseases, Metabolic / Q000209:etiology; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005360:Fibula / Q000473:pathology; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D010002:Osteitis Fibrosa Cystica / Q000175:diagnosis* / Q000473:pathology; D010014:Osteolysis / Q000175:diagnosis / Q000473:pathology; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D016105:Parathyroidectomy; D013977:Tibia / Q000473:pathology
D010281:Parathyroid Hormone