Abstract
‘Brown tumors’ are known as ‘osteitis fibrosa cystica’ or ‘Von Recklinghausen’s disease’ of the bone. A high index of suspicion is required by the treating doctor for diagnosing a ‘brown tumor’ in its early stage. Clinical suspicion, along with laboratory and radiological investigations, is required to diagnose this condition. We present a case of a 65-year-old woman who had multiple bony lesions and a thyroid nodule, which was initially considered as a metastatic bone disease, but later turned out to be ‘brown tumors.' In all cases with multiple osteolytic lesions, a possibility of ‘brown tumor’ must be kept in mind.
Highlights
'Brown tumors' are known as 'osteitis fibrosa cystica' or 'Von Recklinghausen's disease' of the bone
Surgical biopsy is a gold standard in the diagnosis, but radiological findings and biochemical tests, including serum parathyroid hormone (PTH), vitamin D level, etc., help in making the diagnosis
We present a case of a 65-year-old woman who had multiple bony lesions and a thyroid nodule, which were initially considered to be metastatic bone disease, but later turned out to be ‘brown tumor'
Summary
‘Brown tumor’ is a rare manifestation of prolonged hyperparathyroidism (primary, secondary, or tertiary) and has always been a subject of tremendous interest in orthopaedics [1,2]. A plain radiograph of the lumbosacral spine (Figure 4) revealed an osteolytic lesion of the L3 vertebral body Based on these test results and clinical features, a diagnosis of ‘brown tumor’ due to secondary hyperparathyroidism (arising from severe Vitamin D deficiency) was made. The patient responded dramatically well to high-dose Vitamin D supplementation and calcium therapy, and her biochemical parameter, including serum PTH, and serum Vitamin D came to a normal range after two months of treatment. She started walking again with the help of a walker after three weeks and the back pain was alleviated significantly
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