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A case of multiple skeletal lesions of brown tumors, mimicking carcinoma metastases

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Brown tumor is not a true tumor, being an unusual reactive lesion in association with primary or secondary hyperparathyroidism. We report a 23-year-old woman, who initially presented with lower back pain caused by ureterolithiasis. The initial diagnosis of brown tumor was delayed, but later pain in her leg worsened and a sacral lesion was incidentally discovered on lumbar magnetic resonance imaging (MRI); multiple destructive bone lesions were then found radiologically. The radiological features of the multiple bone lesions, which mimicked multiple metastatic tumors, seemed to be those of the terminal stage of malignancy. However, pathological examination and abnormal laboratory data showing elevated serum calcium, alkaline phosphatase, and parathyroid hormone and low serum phosphate confirmed the diagnosis of brown tumor. Adenoma in the parathyroid gland was confirmed and surgically resected. The clinical symptoms of bone pain, and abnormal radiological findings and laboratory data were resolved 6 months after surgery. Synthetic analysis of the clinical, radiological, and laboratory findings was necessary for the definite diagnosis of brown tumor.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 2-9-26 Awaji, higashi-yodogawa-ku, Osaka, 533-0032, Japan

    Manabu Hoshi, Masatsugu Takami, Takashi Okamoto & Ikuhisa Yanagida

  2. Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan

    Manabu Hoshi & Akira Matsumura

  3. Department of Internal Medicine, Yodogawa Christian Hospital, 2-9-26 Awaji, higashi-yodogawa-ku, Osaka, 533-0032, Japan

    Michiko Kajikawa

  4. Department of Pathology, Yodogawa Christian Hospital, 2-9-26 Awaji, higashi-yodogawa-ku, Osaka, 533-0032, Japan

    Kazuhiro Teramura

Authors
  1. Manabu Hoshi
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  2. Masatsugu Takami
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  3. Michiko Kajikawa
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  4. Kazuhiro Teramura
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  5. Takashi Okamoto
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  6. Ikuhisa Yanagida
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  7. Akira Matsumura
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Correspondence to Manabu Hoshi.

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Hoshi, M., Takami, M., Kajikawa, M. et al. A case of multiple skeletal lesions of brown tumors, mimicking carcinoma metastases. Arch Orthop Trauma Surg 128, 149–154 (2008). https://doi.org/10.1007/s00402-007-0312-0

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  • DOI: https://doi.org/10.1007/s00402-007-0312-0

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