Multiple brown tumors: unusual presentation of parathyroid carcinoma
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Abstract
Brown tumors represent the terminal stage of the remodeling process during hyperparathyroidism, and it is a rare clinical presentation of primary hyperparathyroidism. Parathyroid carcinoma is even more rare cause of primary hyperparathyroidism. This is a report of a multiple brown tumor caused by primary hyperparathyroidism secondary to parathyroid carcinoma. A 41-year-old woman, who was presented with a generalized bony pain and pathological fracture of left humerus. X-ray demonstrated lytic lesion in bilateral humerus and left ulna. Laboratory investigations showed hypercalcemia and hypophosphatemia with elevated parathyroid hormone level. Ultrasonography did not reveal any parathyroid lesion, whereas radionuclide Sestamibi scan delineated a focus of abnormal tracer uptake in the lower pole region of right lobe of thyroid, left maxilla, bilateral humerus, and left clavicle. She underwent right inferior
parathyroidectomy, right hemithyroidectomy and central node dissection. Histological diagnosis confirmed parathyroid carcinoma. The rarity and the interesting clinical presentation of such association are discussed.
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