Endocrine Abstracts

Introduction: Brown tumor–well circumscribed lytic lesion is one of the complication of advanced stage of primary and secondary hyperparathyroidism. It may be also a first clinical sign of primary hyperparathyroidism. Nowadays this is rare manifestation in developed countries due to increased use of routine screening laboratory examinations. Brown tumors may also mimic true neoplasm and lead to misdiagnosis if close attention is not paid. We present three case reports and imaging documentation of patients admitted to our hospital with brown tumors – in two cases as first and in one case as a final manifestation of primary hyperparathyroidism.

Case report: We present a case report of 30-year-old pregnant woman (admitted at 31 week of first pregnancy) without medical past history with pelvic localization of brown tumor and a case of 54-year-old woman without medical past history with the brown tumor localized in left tibia. We finally present a case report of 36-year-old patient with long history of treatment of advanced osteoporosis, with nephrocalcinosis, after vertebroplasty of 7th and 12th thoracic vertebrae and after acute pancreatitis episode and pathological fracture of left humerus. The primary hyperparathyroidism was finally diagnosed after brown tumors localized in right foot were found.

Conclusions: i) Despite the rare occurrence of brown tumors it still can be the first manifestation of primary hyperparathyroidism.

ii) Despite many publications there is constant need of reminding about radiological and clinical manifestations of primary hyperparathyroidism, not only in endocrinological but also other specialities (orthopedical, radiological, etc.) journals. It may facilitate prompt diagnosis of this destructive disease.