Authors: Adel Ekladious.
Brown tumors are a rare non-neoplastic, osteolytic lesion caused by an increase in osteoclastic bone resorption. The increase in bone breakdown often leads to patients developing hypercalcemia and osteopenia as a result. Hypercalcemia associated with brown tumors arise due to primary, secondary, or tertiary hyperparathyroidism and in rare cases, occur from the development of a parathyroid gland carcinoma. Most cases of brown tumors are asymptomatic, however, on occasion it can present with pain or compressive symptoms. Common sites for these tumors include clavicle, ribs, pelvis, long bones, maxilla, and mandible. Additionally, it should be noted that brown tumors affect trabecular bone more frequently than cancellous bone.
We will be looking at a 35-year-old male patient who presented with chest pain. He was investigated thoroughly with blood tests, echocardiogram, coronary angiogram, bone marrow trephine biopsy, whole body CT scan, CT- PET scan and finally with excision rib biopsy. Only upon the excision, rib biopsy was the diagnosis of brown tumor confirmed. The development of this tumor was determined to be secondary to primary hyperparathyroidism. Following surgical treatment for hyperparathyroidism, the brown tumor resolved spontaneously.
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