Incidental Diagnosis of a Brown Tumor Mimicking Bone and Lung Metastasis during a Parathyroid Scintigraphy

Fabrice Fokoué,Nadia Abaouz,Sanae El Mselmi,Nadia Ismaili Alaoui

doi:10.4236/ami.2020.102002

Abstract

We report herein a case of a 40-year-old male patient with chronic renal failure presenting a severe hyperparathyroidism with an elevation of parathormone level evaluated in nuclear medicine department for MIBI-Technetium-99m parathyroid scintigraphy. The parathyroid scintigraphy revealed the appearance of a preferential fixation of the MIBI-99mTc opposite the lower left pole of the thyroid and opposite the upper part of the right hemi thorax. A subsequent single-photon emission computed tomography-computed tomography focused on the cervico-thoracic region was performed and showed an ectopic parathyroid adenoma associated with an incidental brown tumor mimicking bone and lung metastases. Our case report confirms the usefulness of additional hybrid SPECT-CT imaging in the management of hyperparathyroidism.

Highlights

Brown tumors are rare osteolytic bone lesions found in 4.5% of patients with primary hyperparathyroidism (PHPT) and 1.5% to 1.7% of patients with secondary hyperparathyroidism (SHPT)
We report a case of a 40-year-old male patient with chronic renal failure presenting a severe hyperparathyroidism with an elevation of parathormone level evaluated in nuclear medicine department for MIBI-Technetium99m parathyroid scintigraphy
We report the case of a patient referred for isotopic exploration looking for a parathyroid adenoma in a context of secondary hyperparathyroidism in which the parathyroid scintigraphy and the complement by SPECT/CT scan allowed to highlight an associated ectopic parathyroid adenoma with a brown tumor mimicking bone and lung metastases allowing to plane best care for this patient after an accurate diagnosis

Summary

Introduction

Brown tumors are rare osteolytic bone lesions found in 4.5% of patients with primary hyperparathyroidism (PHPT) and 1.5% to 1.7% of patients with secondary hyperparathyroidism (SHPT). They can affect the entire skeleton and the most common locations are the pelvis, ribs, mandible and hands. Localizations on the long bones are extremely rare.

Fokoué et al DOI

Patient and Method

Results

Discussion

Conclusion