Osteitis Fibrosa Cystica Mistaken for Malignant Disease.
- Author:
Ja Hyun LEE
1
;
Sung Min CHUNG
;
Han Su KIM
Author Information
1. Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
- Publication Type:Case Report
- Keywords:
Hyperparathyroidism;
Osteitis fibrosa cystica;
Brown tumor
- MeSH:
Back Pain;
Biopsy;
Biopsy, Fine-Needle;
Calcium;
Femur;
Fractures, Spontaneous;
Humans;
Hyperparathyroidism;
Hyperparathyroidism, Primary;
Magnetic Resonance Imaging;
Multiple Myeloma;
Neck;
Neoplasm Metastasis;
Osteitis;
Osteitis Fibrosa Cystica;
Parathyroid Glands;
Parathyroid Hormone;
Parathyroidectomy;
Pelvis;
Spinal Cord;
Spine
- From:Clinical and Experimental Otorhinolaryngology
2013;6(2):110-113
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 65-year-old man with back pain had plain radiographs that showed multiple osteolytic bone lesions of the pelvis, femur and L-spine; an magnetic resonance imaging scan of the L-spine showed extensive bony resorption with a posterior epidural mass involving the L1 spinous process; these findings suggested multiple myeloma or bony metastasis. However, all serology testing was negative. The parathyroid hormone and serum calcium levels were found to be abnormally elevated. A fine needle aspiration biopsy suggested that the L-spine lesion was consistent with the diagnosis of osteitis fibrosa cystica. A pathological fracture of the spine compressed the spinal cord, and surgical intervention was required. The neck computed tomography and Tc-99m sestamibi scan showed a solitary parathyroid mass. A minimally invasive parathyroidectomy using intraoperative parathyroid hormone monitoring was performed and two enlarged parathyroid glands identified. This case illustrates the importance of the consideration of a rare brown tumor associated with primary hyperparathyroidism in patients with the bone lesions suggestive of a malignancy.
