title: Multiple brown tumours from parathyroid carcinoma.
abstract: We report a case of a 29-year-old woman who suffered from severe bilateral inguinal pain and left mandibular mass. CT scan showed innumerable expansile osteolytic bone masses on the iliac wings, femur, ribs and vertebral bodies, diffuse skeletal osteopaenia, calyceal lithiasis on the right kidney and a left thyroid mass. Ionised calcium and intact parathyroid hormone (PTH) were elevated. Parathyroid sestamibi scan showed a hyperfunctioning left inferior parathyroid gland. Biopsy of the left mandibular mass was consistent with brown tumour. The patient underwent parathyroidectomy of the enlarged parathyroid gland. Final histopathology, however, revealed parathyroid carcinoma, 4.7 cm in widest dimension, with capsular and vascular space invasion. The patient underwent repeat surgery, specifically, left thyroid lobectomy, isthmectomy and central node dissection. Intact PTH decreased from 681.3 to 74 pg/mL (normal range: 10-65) 24 hours postoperatively. Follow-up at 6 months showed normal serum calcium levels, size reduction of bone lesions and improvement of quality of life.
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors.forename: Daryl Jade Tardo
authors.initials: DJ
authors.lastname: Dagang
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors.forename: Jerico Baliton
authors.initials: JB
authors.lastname: Gutierrez
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors.forename: Mark Anthony Santiago
authors.initials: MA
authors.lastname: Sandoval
authors.affiliation: Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors.forename: Frances Lina
authors.initials: FL
authors.lastname: Lantion-Ang
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001859:Bone Neoplasms / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D006101:Granuloma, Giant Cell / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008336:Mandibular Diseases / Q000175:diagnosis / Q000209:etiology; D010014:Osteolysis / Q000175:diagnosis* / Q000209:etiology; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed