Endocrine Abstracts

Introduction: Primary hyperparathyroidism revealed by multiple brown tumors is rare. We report the case of a patient with primary hyperparathyroidism on parathyroid adenoma discovered in front of multiple brown tumors.

Case Presentation: A 72-year-old female patient, who presented for 6 months a functional impotence of both lower limbs with paraparesis, associated with bone pain from where the realization of a phospho-calcium assessment returning in favor of an hyperparathyroidism. The diagnosis of localization confirmed the presence of a parathyroid adenoma. It also showed the presence of bone masses at the level of the scapulae, right clavicle, at the level of the costal, dorsal vertebrae with a medullar compression. A bone biopsy was performed showing an aspect in favor of multiple brown tumors. The patient underwent a medullary decompression surgery as well as a parathyroid surgery after normalization of the phospho-calcium balance. The postoperative course was simple with a good evolution.

Discussion and Conclusion: A brown tumor is a benign bone lesion caused by localized and rapid osteoclastic turnover resulting from hyperparathyroidism. Hyperparathyroidism revealed by multiple brown tumors is rare, few cases are reported in the literature and they are rarely described in the axial skeleton as in our patient’s case. Its diagnosis is often difficult in the presence of polyostotic lytic lesions with hypercalcemia mimicking bone metastases. Bone manifestations are rarely revealing of the disease since they are present only at a late stage and are seen in only 2% of cases.