scholarly journals Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Legault ◽  
M. Inman ◽  
N. Moolman ◽  
S. Wiebe ◽  
A. Poulin ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Bone Lesion ◽  
Lytic Lesion ◽  
Pharmacologic Therapy ◽  
Brown Tumor ◽  
Systemic Complications ◽  
Diagnosis And Management ◽  
General Pediatrician ◽  
Severe Hypercalcemia ◽  
Definitive Therapy

Abstract Background Primary hyperparathyroidism may present in a myriad of manners, varying from an incidental asymptomatic biochemical finding to gastrointestinal, psychiatric, renal, and bone manifestations. While hyperparathyroidism remains a rare diagnosis in the pediatric population, the initial approach to diagnosis and management of hypercalcemia in children is imperative for the general pediatrician. Herein, we describe an adolescent who presented with a lytic bone lesion and severe, symptomatic hypercalcemia due to primary hyperparathyroidism. Case presentation A 14-year-old male presented with vomiting, constipation, abdominal pain, and lethargy. He had an elevated total corrected calcium of 4.3 mmol/L. He was found to have a large pelvic lytic tumor consistent with a brown tumor due to primary hyperparathyroidism. He received pharmacologic therapy for stabilization of his hypercalcemia, including intravenous saline, intravenous bisphosphonates, and calcitonin. He subsequently received definitive therapy via parathyroidectomy and his post-operative course was complicated by hungry bone syndrome. Long-term follow-up has found full resolution of the lytic lesion and restored calcium homeostasis. Conclusions We present this case to highlight the possible presentations of hypercalcemia and hyperparathyroidism that are essential for a general pediatrician to recognize to ensure prompt diagnosis and management. Evaluation for hypercalcemia should be considered in patients with suggestive symptoms and physical exam findings. To our knowledge, this patient represents the first reported pediatric case of a pelvic brown tumor in an adolescent. While the multi-systemic complications of hyperparathyroidism may be quite severe, swift and appropriate management may mitigate these clinical outcomes.

scholarly journals A Reference Finding Rarely Seen in Primary Hyperparathyroidism: Brown Tumor

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
F. Mantar ◽  
S. Gunduz ◽  
U. R. Gunduz
Keyword(s):  
Bone Loss ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Male Patient ◽  
Surgical Procedures ◽  
Bone Disease ◽  
Bone Lesion ◽  
Brown Tumor ◽  
Osteitis Fibrosa Cystica ◽  
Localized Form

Primary hyperparathyroidism is an endocrinopathy which is characterized with the hypersecretion of parathormone. During the progress of the disease bone loss takes place due to resorption on the subperiosteal and endosteal surfaces. Brown tumor is a localized form of osteitis fibrosa cystica, being part of the hyperparathyroid bone disease. It is rarely the first symptom of hyperparathyroidism. Nowadays, the diagnosis is made at an asymptomatic or minimally symptomatic stage. We present a male patient presented with a massive painless swelling in the left maxilla as the first manifestation of primary hyperparathyroidism due to a parathyroid adenoma. Parathyroidectomy was performed, and there was a regression of the bone lesion, without the need of performing other local surgical procedures.

scholarly journals Brown tumor due to primary hyperparathyroidism resulting in acute paraparesis: Case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 355
Author(s):  
Ahmed Taha Elsayed Shaaban ◽  
Mostafa Ibrahem ◽  
Ahmed Saleh ◽  
Abdulrazzaq Haider ◽  
Abdulnasser Alyafai
Keyword(s):  
Primary Hyperparathyroidism ◽  
Bone Lesion ◽  
Excisional Biopsy ◽  
Brown Tumor ◽  
Parathyroid Tumor ◽  
Osteitis Fibrosa Cystica ◽  
Lytic Bone Lesion ◽  
Brown Tumors ◽  
Acute Paraparesis ◽  
Operative Decompression

Background: Brown tumor (Osteoclastoma) is a rare benign, focal, lytic bone lesion most commonly attributed to a parathyroid adenoma; it occurs in approximately 5% of patients with primary hyperparathyroidism, and 13% of patients with secondary hyperparathyroidism. Most tumors are located in the mandible, pelvis, ribs, and large bones; only rarely is it found in the axial spine. Case Description: A 37-year-old male with primary hyperparathyroidism presented with an MR-documented T4 and T5 brown tumor (Osteitis Fibrosa Cystica) resulting in an acute paraparesis. The patient successfully underwent excisional biopsy of an expansile, enhancing, bony destructive lesion at the T4-5 level. Subsequently, he required subtotal excision of a left upper parathyroid tumor. Conclusion: Patient with primary hyperparathyroidism may acutely present with paraparesis attributed to brown tumors of the spine warranting emergent operative decompression.

scholarly journals Primary Hyperparathyroidism in Pregnancy: Literature Review of the Diagnosis and Management

2021 ◽  
Vol 10 (13) ◽  
pp. 2956
Author(s):  
Dalal S. Ali ◽  
Karel Dandurand ◽  
Aliya A. Khan
Keyword(s):  
Primary Hyperparathyroidism ◽  
Case Reports ◽  
Safety Data ◽  
Case Series ◽  
Close Monitoring ◽  
Management Options ◽  
Diagnosis And Management ◽  
Severe Hypercalcemia ◽  
Fetal Complications ◽  
In Pregnancy

Background: Parathyroid disease is uncommon in pregnancy. During pregnancy, multiple changes occur in the calcium regulating hormones which may make the diagnosis of primary hyperparathyroidism more challenging. Close monitoring of serum calcium during pregnancy is necessary in order to optimize maternal and fetal outcomes. In this review, we will describe the diagnosis and management of primary hyperparathyroidism during pregnancy. Methods: We searched MEDLINE, CINAHL, EMBASE and Google scholar bases from 1 January 1990 to 31 December 2020. Case reports, case series, book chapters and clinical guidelines were included in this review. Conclusions: Medical management options for primary hyperparathyroidism during pregnancy are severely limited due to inadequate safety data with the various potential therapies available, and surgery is advised during the 2nd trimester of pregnancy in the presence of severe hypercalcemia (calcium adjusted for albumin greater than 3.0 mmol/L (12.0 mg/dL)). Hypercalcemia should be avoided during pregnancy in order to minimize maternal and fetal complications.

scholarly journals Multiple Brown Tumors in a Normocalcemic Patient with Primary Hyperparathyroidism - A Case Report

2019 ◽  
Vol 22 (1) ◽  
pp. 68-72
Author(s):  
Nazmun Nahar ◽  
Nasim Khan ◽  
Ratan Kumar Chakraborty ◽  
Shakila Zaman Rima ◽  
Nadiruzzaman ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Malignant Disease ◽  
Bone Lesion ◽  
Direct Result ◽  
Initial Symptom ◽  
Brown Tumor ◽  
Bony Tissue ◽  
Benign Bone Lesion ◽  
Brown Tumors ◽  
Real Challenge

Brown tumor is a benign bone lesion that arises as a direct result of parathyroid hormone on bony tissue in some patients with hyperparathyroidism. Multiple brown tumors may simulate malignant disease and it is a real challenge for the clinicians in the differential diagnoses. Brown tumor as the only and initial symptom of normocalcemic primary hyperparathyroidism is a rare clinical entity. Here, we present a case with multiple brown tumors in a young normocalcemic woman as a sequele of primary hyperparathyroidism mimicking bone metastases. Bangladesh J. Nuclear Med. 22(1): 68-72, Jan 2019

scholarly journals Sphenoid Brown Tumor Associated with a Parathyroid Carcinoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Abelardo Loya-Solís ◽  
Alejandra Mendoza-García ◽  
Luis Ceceñas-Falcón ◽  
René Rodríguez-Gutiérrez
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Bone Lesion ◽  
Bone Lesions ◽  
Brown Tumor ◽  
Diagnostic Challenge ◽  
Histopathology Result ◽  
History Of ◽  
Persistent Hyperparathyroidism ◽  
Brown Tumors

Brown tumors are osteolytic bone lesions that occur as a result of persistent hyperparathyroidism. They usually appear late in the natural history of the disease and are currently very rare due to an earlier diagnosis of primary hyperparathyroidism. We present the case of a 53-year-old female with a 2-month history of bitemporal hemianopsia and diplopia. A computed tomography showed an osteolytic bone lesion that involved the sphenoid corpus and clivus. A biopsy was made and the histopathology result was consistent with a brown tumor. The aforementioned location is very infrequent to such tumors, and therefore represented a diagnostic challenge. However, in this case, its association to primary hyperparathyroidism was the clue for the diagnosis. The association of a brown tumor secondary to a parathyroid carcinoma has been seldom reported. This case represents, to our knowledge, one of the few brown tumors described in such location and the first secondary to a parathyroid carcinoma.

Audit of the diagnosis and management of primary hyperparathyroidism

2015 ◽  
Author(s):  
Pei Chia Eng ◽  
Langstaff Lorna ◽  
Kaplan Felicity ◽  
Mochloulis George ◽  
Winocour Peter
Keyword(s):  
Primary Hyperparathyroidism ◽  
Diagnosis And Management

A Case of Primary Hyperparathyroidism Associated with Brown Tumor of the Right Patella

2013 ◽  
Vol 64 (3) ◽  
pp. 224-230
Author(s):  
Masanori Teshima ◽  
Shigemichi Iwae ◽  
Yuji Hirayama ◽  
Hirotaka Shinomiya ◽  
Tatsuya Furukawa
Keyword(s):  
Primary Hyperparathyroidism ◽  
Brown Tumor ◽  
The Right

scholarly journals An Unusual Presentation of Primary Hyperparathyroidism: Pathological Fracture

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Ben Abdelghani Khaoula ◽  
Ben Abdelghani Kaouther ◽  
Chelly Ines ◽  
Turki Sami ◽  
Leith Zakraoui ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Female Patient ◽  
Calcium Level ◽  
Pathological Fracture ◽  
Unusual Presentation ◽  
Uneventful Recovery ◽  
Brown Tumor ◽  
Pathological Findings ◽  
Pth Level

Primary hyperparathyroidism revealed by a pathological fracture is very uncommon. We present a case of a 54-year-old female patient who was admitted with fracture of her right femur. She underwent closed intramedullary reconstruction nailing with bipolar locking. The pathological findings confirmed the diagnosis of primary hyperparathyroidism with brown tumor. Further tests showed increased both calcium level and PTH level. A parathyroidectomy was performed. She made an uneventful recovery and was discharged to home.

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