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Brown tumor complicating end-stage kidney disease

Longstanding, severe hyperparathyroidism (HPT) can lead to the formation of “brown tumors”. A brown tumor is a radiolucent bone lesion that is locally destructive; it is not a neoplasm, but rather a stromal mass consisting of fibrous tissue, poorly mineralized woven bone, and supporting vasculature....

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Autor principal: Wiederkehr, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dustri-Verlag Dr. Karl Feistle 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552353/
https://www.ncbi.nlm.nih.gov/pubmed/33062583
http://dx.doi.org/10.5414/CNCS110195
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author Wiederkehr, Michael
author_facet Wiederkehr, Michael
author_sort Wiederkehr, Michael
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description Longstanding, severe hyperparathyroidism (HPT) can lead to the formation of “brown tumors”. A brown tumor is a radiolucent bone lesion that is locally destructive; it is not a neoplasm, but rather a stromal mass consisting of fibrous tissue, poorly mineralized woven bone, and supporting vasculature. These tumors are a rare complication of advanced primary or secondary HPT. We present a young female with chronic kidney disease (CKD) on hemodialysis with uncontrolled secondary HPT (SHPT). The patient presented with progressive lower extremity weakness and back pain. CT imaging showed multiple lytic bone lesions involving several ribs and the spine. Subsequent MRI imaging of the thoracic and lumbar spine confirmed expansile bone lesions consistent with brown tumors. One mass protruded into the spinal canal causing severe stenosis at T3 with underlying cord edema. The other lesion at T12 caused only moderate spinal canal stenosis. Our patient underwent urgent neurosurgical resection of the tumor at T3 followed by subtotal parathyroidectomy (PTX).
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spelling pubmed-75523532020-10-14 Brown tumor complicating end-stage kidney disease Wiederkehr, Michael Clin Nephrol Case Stud Case Report Longstanding, severe hyperparathyroidism (HPT) can lead to the formation of “brown tumors”. A brown tumor is a radiolucent bone lesion that is locally destructive; it is not a neoplasm, but rather a stromal mass consisting of fibrous tissue, poorly mineralized woven bone, and supporting vasculature. These tumors are a rare complication of advanced primary or secondary HPT. We present a young female with chronic kidney disease (CKD) on hemodialysis with uncontrolled secondary HPT (SHPT). The patient presented with progressive lower extremity weakness and back pain. CT imaging showed multiple lytic bone lesions involving several ribs and the spine. Subsequent MRI imaging of the thoracic and lumbar spine confirmed expansile bone lesions consistent with brown tumors. One mass protruded into the spinal canal causing severe stenosis at T3 with underlying cord edema. The other lesion at T12 caused only moderate spinal canal stenosis. Our patient underwent urgent neurosurgical resection of the tumor at T3 followed by subtotal parathyroidectomy (PTX). Dustri-Verlag Dr. Karl Feistle 2020-10-12 /pmc/articles/PMC7552353/ /pubmed/33062583 http://dx.doi.org/10.5414/CNCS110195 Text en © Dustri-Verlag Dr. K. Feistle http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Wiederkehr, Michael
Brown tumor complicating end-stage kidney disease
title Brown tumor complicating end-stage kidney disease
title_full Brown tumor complicating end-stage kidney disease
title_fullStr Brown tumor complicating end-stage kidney disease
title_full_unstemmed Brown tumor complicating end-stage kidney disease
title_short Brown tumor complicating end-stage kidney disease
title_sort brown tumor complicating end-stage kidney disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552353/
https://www.ncbi.nlm.nih.gov/pubmed/33062583
http://dx.doi.org/10.5414/CNCS110195
work_keys_str_mv AT wiederkehrmichael browntumorcomplicatingendstagekidneydisease