Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review
Abstract Background Brown tumour is a rare tumour-like lesion of the bone, which is considered as an end-stage lesion of abnormal bone metabolism caused by persistently high parathyroid hormone (PTH) levels. Brown tumour can be found in any part of the skeleton; in some cases, it can occur in multip...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12902-022-00971-2 |
| _version_ | 1818571704692113408 |
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| author | Yanchun Zhong Yuxi Huang Jiaquan Luo Yongjun Ye |
| author_facet | Yanchun Zhong Yuxi Huang Jiaquan Luo Yongjun Ye |
| author_sort | Yanchun Zhong |
| collection | DOAJ |
| description | Abstract Background Brown tumour is a rare tumour-like lesion of the bone, which is considered as an end-stage lesion of abnormal bone metabolism caused by persistently high parathyroid hormone (PTH) levels. Brown tumour can be found in any part of the skeleton; in some cases, it can occur in multiple bones and can be easily misdiagnosed as a metastatic tumour. Case presentation We report the case of a 44-year-old man who presented to the Department of Oncology in our hospital with a 2-month history of local pain in his left shoulder joint. The initial diagnosis was an aneurysmal bone cyst by biopsy, for which the patient underwent tumour resection surgery. The diagnosis of a malignant tumour was made again following postoperative pathological examination. The pathological sections and all clinical data were sent to the Department of Pathology of the First Affiliated Hospital of Sun Yat-sen University; the diagnosis made there was brown tumour. His blood PTH level was 577 pg/ml (15–65 pg/ml). Colour Doppler ultrasonography of the parathyroid gland suggested a parathyroid adenoma. For further treatment, the left parathyroid adenoma was removed by axillary endoscopic resection. Postoperatively, a pathologic examination was performed, and the diagnosis of a parathyroid adenoma was confirmed. One year after the surgery, the left humerus was completely healed, and the left shoulder joint had a good range of movement. Conclusions In summary, histopathological diagnosis is not sufficient for the diagnosis of brown tumours. A comprehensive analysis combining clinical symptoms with findings of imaging and laboratory tests is also required. Generally, the treatment of brown tumour includes only partial or complete resection of the parathyroid glands. However, when the tumour is large, especially when it involves the joint, surgery is indispensable. |
| first_indexed | 2024-12-14T18:47:53Z |
| format | Article |
| id | doaj.art-145fe00192494cfc87707c645cc6490b |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-14T18:47:53Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-145fe00192494cfc87707c645cc6490b2022-12-21T22:51:20ZengBMCBMC Endocrine Disorders1472-68232022-03-012211810.1186/s12902-022-00971-2 Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature reviewYanchun Zhong0Yuxi Huang1Jiaquan Luo2Yongjun Ye3Department of spine surgery, First Affiliated Hospital of Gannan Medical UniversityDepartment of basic medicine, Gannan Health Vocational CollegeDepartment of spine surgery, First Affiliated Hospital of Gannan Medical UniversityDepartment of spine surgery, First Affiliated Hospital of Gannan Medical UniversityAbstract Background Brown tumour is a rare tumour-like lesion of the bone, which is considered as an end-stage lesion of abnormal bone metabolism caused by persistently high parathyroid hormone (PTH) levels. Brown tumour can be found in any part of the skeleton; in some cases, it can occur in multiple bones and can be easily misdiagnosed as a metastatic tumour. Case presentation We report the case of a 44-year-old man who presented to the Department of Oncology in our hospital with a 2-month history of local pain in his left shoulder joint. The initial diagnosis was an aneurysmal bone cyst by biopsy, for which the patient underwent tumour resection surgery. The diagnosis of a malignant tumour was made again following postoperative pathological examination. The pathological sections and all clinical data were sent to the Department of Pathology of the First Affiliated Hospital of Sun Yat-sen University; the diagnosis made there was brown tumour. His blood PTH level was 577 pg/ml (15–65 pg/ml). Colour Doppler ultrasonography of the parathyroid gland suggested a parathyroid adenoma. For further treatment, the left parathyroid adenoma was removed by axillary endoscopic resection. Postoperatively, a pathologic examination was performed, and the diagnosis of a parathyroid adenoma was confirmed. One year after the surgery, the left humerus was completely healed, and the left shoulder joint had a good range of movement. Conclusions In summary, histopathological diagnosis is not sufficient for the diagnosis of brown tumours. A comprehensive analysis combining clinical symptoms with findings of imaging and laboratory tests is also required. Generally, the treatment of brown tumour includes only partial or complete resection of the parathyroid glands. However, when the tumour is large, especially when it involves the joint, surgery is indispensable.https://doi.org/10.1186/s12902-022-00971-2Brown tumourPrimary hyperparathyroidismMisdiagnosisParathyroid carcinomaCase report |
| spellingShingle | Yanchun Zhong Yuxi Huang Jiaquan Luo Yongjun Ye Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review BMC Endocrine Disorders Brown tumour Primary hyperparathyroidism Misdiagnosis Parathyroid carcinoma Case report |
| title | Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review |
| title_full | Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review |
| title_fullStr | Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review |
| title_full_unstemmed | Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review |
| title_short | Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review |
| title_sort | misdiagnosis of brown tumour caused by primary hyperparathyroidism a case report with literature review |
| topic | Brown tumour Primary hyperparathyroidism Misdiagnosis Parathyroid carcinoma Case report |
| url | https://doi.org/10.1186/s12902-022-00971-2 |
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