ECE2006 Poster Presentations Bone (46 abstracts)
Brown tumors in hyperparathyroidism may be mistaken for primitive bone neoplasia: report of two cases
CA Rota , F Ingraudo , RM Paragliola , MP Ricciato , AL Bilotta , F Ianni , F Gallo , G Ubertini , SM Corsello & A Pontecorvi
Catholic University, Rome, Italy.
Primary hyperparathyroidism is characterized by abnormal PTH secretion from one or more hyperfunctioning parathyroids and hypercalcemia. PTH exerts a catabolic effect on the cortical bone resulting in the osteitis fibrosa cystica. Two patients were referred to us after destroyed surgery for brown tumors mistaken for primitive bone tumors.
A 59 years old man was referred to emergency department for a pathologic fracture of the left hip. The X-ray showed a bone diaphysis osteolytic lesion, the calcemia was 15 mg/dl. A biopsy was performed and resection of the bone segment followed. Hystology was: ‘neoplasm consisting of vascular lacunae bordered by multinucleated giant cells embedded in a fibrillary network (giant cells tumor or aneurysmatic bone cyst)’.
Five months later the patient was referred to the endocrinologist because of persistently high calcemia (14 mg/dl), with serum PTH levels 1638 pg/ml. Parathyroid scan revealed: ‘hyperfunction parathyroid in the right side’ and the patient underwent upper right parathyroidectomy through a minimally invasive technique. The histological examination confirmed the parathyroid adenoma.
A 67 years old women was referred to us following amputation of the left leg for a supposed primitive bone tumor. Serum PTH was 2185 pg/ml and calcemia 13.6 mg/dl indicating primary hyperparathyroidism. Parathyroid scan revealed a hyperfunction parathyroid in the right side. The patient underwent excision of the upper right parathyroid; Hystology revealed a parathyroid carcinoma.
The above two cases suggest that, when X-ray shows an osteolytic lesion, PTH and calcemia should be performed in order to exclude the presence of primary hyperparathyroidism.
Primary hyperparathyroidism can be treated with minimally invasive surgical techniques, thereby sparing the patient invalidating surgery due to wrong diagnosis.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more