Brown Tumor of Lower Right Limb in Patients With Primary Hyperparathyroidism: A Case Report

Background.Brown tumor of Hyperparathyroidism is a metabolic disorder that can affect the entire skeleton and reactive process due to bone resorption caused by primary or secondary hyperparathyroidism (HPT). Brown tumors can occur as solitary or multiple lesions in any bone, most often in the pelvis, ribs, clavicle, mandibula, and extremities. Here, we report the Brown tumor in the lower right limb in patients with primary HPT, and the literature is reviewed. Case presentation. Patients was women 30 years old had married and come with main complains of difficulty walking. This condition has been experienced by patients since diagnosis with lunb of tibia last 8 months and caused pain from hip to lower leg. On laboratory results, it showed elevated PTH 1.249 (normal 15-65) pg/dL, elevated phosphatase alkali 1156 (normal 40-150) u/dL, elevated Ca 10,8 (n:8,6 -10,3) mg/dL, phosphor 2,1 (3–4,5) mg/dL. Histology examination of tibia lump was a benign lesion of bone (Brown Tumor). Ultrasonography transabdominal result revealed kidney stones with bilateral renal pelvis dilation, nephrolithiasis non-obstructive was found with size 1 cm & left kidney cyst with size 0.6 cm. On Neck USG showed giant cyst lesion on parathyroid glands. Radiologist pelvic examination results showed bone metastasis disease. Head CT Scan examination concluded as suspect metastatic bone. Body bone scans examination showed pathological bone metastatic process. Conclusion. Brown tumor in right lower limb caused by primary HPT

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A hemodialysis patient with bone disease after pregnancy: a case report

BMC Nephrology ◽

10.1186/s12882-019-1603-8 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Hannelore Sprenger-Mähr ◽

Emanuel Zitt ◽

Andreas Kronbichler ◽

Manfred Cejna ◽

Karl Lhotta

Keyword(s):

Bone Health ◽

Brown Tumor ◽

Dialysis Patients ◽

Gradual Improvement ◽

Case Presentation ◽

Skeletal Complications ◽

Brown Tumors ◽

End Stage ◽

Dialysis Time ◽

Dialysate Calcium

Abstract Background Pregnancy is rare in women on hemodialysis. Recommendations for the treatment of secondary hyperparathyroidism (sHPT) and preservation of bone health in pregnant dialysis patients are lacking. Case presentation We present the case of a young woman with end-stage kidney disease (ESKD) due to lupus nephritis, who developed multiple brown tumors while on hemodialysis during her second pregnancy. During her first pregnancy sHPT was well controlled and no skeletal complications occurred. Before the second pregnancy she developed severe sHPT. During pregnancy, dialysis time was increased to 24 h per week, the patient was given oral calcitriol, and the dialysate calcium concentration was set at 1.5 mmol/l. In week 20 the patient complained about bone pain in her left hip. Magnetic resonance imaging revealed a cystic lesion compatible with a brown tumor. The baby was delivered in the 36th week by cesarean section. Further assessment identified multiple brown tumors of her skeleton, including the acetabulum, tibia, ribs, skull, thoracic spine and thumb. She required multiple orthopedic surgeries. Three months after pregnancy, etelcalcetide was started, which brought about a gradual improvement in her sHPT. Conclusions This case demonstrates that the combination of pregnancy and severe sHPT in dialysis patients can have deleterious consequences for bone health.

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Age- and sex-related bone uptake of Tc-99m-HDP measured by whole-body bone scanning

Nuklearmedizin ◽

10.1055/s-0038-1632258 ◽

2000 ◽

Vol 39 (05) ◽

pp. 127-132 ◽

Cited By ~ 2

Author(s):

Nicole Sieweke ◽

K. H. Bohuslavizki ◽

W. U. Kampen ◽

M. Zuhayra ◽

M. Clausen ◽

...

Keyword(s):

Whole Body ◽

Bone Lesions ◽

Men And Women ◽

Bone Uptake ◽

Normal Bone ◽

Age Related ◽

Number Of Patients ◽

Wide Range ◽

Bone Scans ◽

Body Bone

Summary Aim of this study was to validate a recently introduced new and easy-to-perform method for quantifying bone uptake of Tc-99m-labelled diphosphonate in a routine clinical setting and to establish a normal data base for bone uptake depending on age and gender. Methods: In 49 women (14-79 years) and 47 men (6-89 years) with normal bone scans as well as in 49 women (33-81 years) and 37 men (27-88 years) with metastatic bone disease whole-body bone scans were acquired at 3 min and 3-4 hours p.i. to calculate bone uptake after correction for both urinary excretion and soft tissue retention. Results: Bone uptake values of various age-related subgroups showed no significant differences between men and women (p >0.05 ). Furthermore, no differences could be proven between age-matched subgroups of normals and patients with less than 10 metastatic bone lesions, while patients with wide-spread bone metastases revealed significantly increased uptake values. In both men and women highest bone uptake was obtained (p <0.05 ) in subjects younger than 20 years with active epiphyseal growth plates. In men, bone uptake slowly decreased with age up to 60 years and then showed a tendency towards increasing uptake values. In women, the mean uptake reached a minimun in the decade 20-29 years and then slowly increased with a positive linear correlation of age and uptake in subjects older than 55 years (r = 0.57). Conclusion: Since the results proposed in this study are in good agreement with data from literature, the new method used for quantification could be validated in a large number of patients. Furthermore, age- and sexrelated normal bone uptake values of Tc-99m-HDP covering a wide range of age could be presented for this method as a basis for further studies on bone uptake.

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Castleman Disease of the Kidney in Computed Tomography Urography

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210601153220 ◽

2021 ◽

Vol 17 ◽

Author(s):

Kai Wang ◽

Fengjuan Xing ◽

Heng Ma ◽

Wenjuan Li

Keyword(s):

Computed Tomography ◽

Left Kidney ◽

Castleman Disease ◽

Renal Parenchyma ◽

Case Presentation ◽

Imaging Characteristics ◽

Computed Tomography Urography ◽

Hypervascular Tumors ◽

Cystic Area

Background: Castleman disease (CD) of the kidney is extremely rare. In this study, we presented a case of CD of the left kidney and comprehensively described the findings of computed tomography urography. Case Presentation: The case involved unusual imaging characteristics of the focal central cystic area. Conclusion: The small and regular cyst-like structures and the hyperdense mass relative to the renal parenchyma in plain scans might help distinguish the CD of the kidney from other hypervascular tumors.

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Giant parathyroid adenoma diagnosed by brown tumor, a clinical manifestation of primary hyperparathyroidism: a case report

Journal of the Pakistan Medical Association ◽

10.47391/jpma.393 ◽

2021 ◽

pp. 1-8

Author(s):

Banu Yigit ◽

Mert Tanal ◽

Bulent Citgez

Keyword(s):

Case Report ◽

Primary Hyperparathyroidism ◽

Secondary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Benign Lesion ◽

Brown Tumor ◽

Skeletal System ◽

Radiological Findings ◽

Facial Bones ◽

Osteitis Fibrosa Cystica

Abstract Brown tumor (BT) is the pathological expression of osteitis fibrosa cystica owing to primary and secondary hyperparathyroidism (HPT). It is a rare benign lesion of skeletal system that usually affects the facial bones, clavicles, ribs, pelvis and extremities. The purpose of this case report is to present the clinical, pathological and radiological findings of BT, rarely seen in adults, originating from the giant parathyroid adenoma and emerging as the first clinical sign of HPT. The patient underwent a successful parathyroidectomy operation and on the first postoperative day, the patient was discharged without any complications. Continuous...

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Primitive neuroectodermal tumour of the kidney: An unusual case mimicking renal angiomyolipoma with minimal fat

Canadian Urological Association Journal ◽

10.5489/cuaj.2581 ◽

2015 ◽

Vol 9 (5-6) ◽

pp. 337 ◽

Cited By ~ 1

Author(s):

Jing Xie ◽

Jin Wen ◽

Ya-lan Bi ◽

Han-zhong Li

Keyword(s):

Ct Scan ◽

Benign Lesion ◽

Left Kidney ◽

Immunohistochemical Analysis ◽

Renal Angiomyolipoma ◽

Primitive Neuroectodermal Tumour ◽

Neuroectodermal Tumour ◽

Positron Emission ◽

The Central Nervous System ◽

Minimal Fat

Primitive neuroectodermal tumour (PNET) is a highly aggressive neoplasm that develops classically in the central nervous system. PNET of the kidney (rPNET) is extremely rare. Recently, a 23-yearold woman complained of left flank pain and intermittent hematuria for 3 months and was admitted to our hospital. A computed tomography (CT) scan and magnetic resonance imaging demonstrated a 5.1 × 4.4-cm heterogenous mass with unconspicuous reinforcement in the upper pole of the left kidney. F18-FDG positron emission tomography CT (PET-CT) revealed the mass as a benign lesion with internal extensive bleeding. Renal angiomyolipoma with minimal fat was diagnosed. Three months later, a CT scan showed that the mass shrank to 3.1 × 2.6 cm and nephron-sparing surgery of the left kidney was performed at the patient’s request. However, histologic features and immunohistochemical analysis confirmed the diagnosis of rPNET. Five cycles of combined chemotherapy were executed. At the 11-month follow-up, the patient showed no evidence of metastasis or recurrence.

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Renal abscess with bacteremia caused by extended-spectrum β-lactamase-producing Escherichia coli: a case report

BMC Pediatrics ◽

10.1186/s12887-020-02366-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hiroki Kitaoka ◽

Jun Inatomi ◽

Hayato Chikai ◽

Keiko Watanabe ◽

Tadayuki Kumagai ◽

...

Keyword(s):

Escherichia Coli ◽

Renal Scarring ◽

Left Kidney ◽

Severe Form ◽

Healthy Children ◽

Renal Abscess ◽

Case Presentation ◽

E Coli ◽

Extended Spectrum ◽

Low Density Area

Abstract Background Renal abscess in children is a rare and severe form of infectious kidney disease that is responsible for several serious complications. In this report, we describe a previously healthy 5-year-old girl with a renal abscess caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli), which led to bacteremia and renal scarring. Case presentation The patient presented to our department with high fever, headache, vomiting for 2 days and high inflammatory response. We diagnosed her with a urinary tract infection and initiated treatment with ampicillin and cefotaxime. Gram-negative bacilli bacteremia was noted on day 3. On day 4, her fever persisted, and a computed tomography (CT) scan revealed a renal abscess in the left kidney. After identifying the bacteria as ESBL-producing E. coli from the blood culture, we switched to the antibiotic meropenem and continued treatment for 3 weeks. The renal abscess was not drained. Although the renal abscess was successfully treated and it disappeared, a low-density area remained in same lesion on subsequent CT scans and a dimercaptosuccinic acid renal scan performed 4 months after onset revealed renal scarring. Conclusion Given the increasing prevalence of ESBL-producing microorganisms, clinicians should be aware of the possibility of renal abscesses caused by community-acquired ESBL-producing organisms even in previously healthy children. Once a renal abscess is suspected, early diagnosis and management are important for reducing the risk of life-threating complications and renal scarring.

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