Abstract:
Brown tumors, resulting from elevated osteoclast activity, are uncommon skeletal symptoms of hyperparathyroidism. Because of their similar characteristics, it is challenging to differentiate these tumors from multiple myeloma or osteolytic metastases. A 24-year-old female with a painful lump in her left thigh and arm in the past 10 months. The patient reported a history of left femoral bone fracture over a year ago due to low-impact trauma. Plain radiograph images and chest MSCT showed osteolytic lesions at the skull, ribs, and extremities, followed by increased Tc99 bone scan image uptake. Thyroid ultrasound and cervical MSCT showed parathyroid mass. Biochemical and pathologic examination supported the diagnosis of brown tumor. A multidisciplinary approach, including clinical evaluation, biochemical assessment, pathological examination, and advanced imaging modalities such as CT scan, MRI, and bone scintigraphy, is necessary for the differential diagnosis of brown tumors from bone metastasis. Medical history, PTH, calcium levels in the blood, and additional systemic symptoms can all be used to help distinguish between the 2 disorders. The clinical presentation and imaging findings of brown tumors may mimic bone metastasis, necessitating comprehensive evaluation. Multidisciplinary collaboration plays a vital role in reaching an accurate diagnosis. Increased awareness of brown tumors as a potential mimic of bone metastasis may help prevent misdiagnosis and ensure optimal care for patients presenting with osteolytic bone lesions associated with hyperparathyroidism.
摘要:
棕色肿瘤,由于破骨细胞活性升高,是罕见的甲状旁腺功能亢进的骨骼症状。由于它们相似的特点,将这些肿瘤与多发性骨髓瘤或溶骨性转移区分开来具有挑战性.一名24岁的女性,在过去的10个月里,她的左大腿和手臂有一个疼痛的肿块。该患者报告了一年多前由于低冲击创伤导致的左股骨骨折的病史。X线平片和胸部MSCT显示颅骨溶骨性病变,肋骨,和四肢,其次是增加Tc99骨扫描图像摄取。甲状腺超声及颈部MSCT显示甲状旁腺肿块。生化和病理检查支持棕色肿瘤的诊断。多学科方法,包括临床评估,生化评估,病理检查,和先进的成像模式,如CT扫描,MRI,和骨闪烁显像,对于棕色肿瘤和骨转移的鉴别诊断是必要的。病史,PTH,血液中的钙水平,和其他全身症状都可以用来帮助区分这两种疾病。棕色肿瘤的临床表现和影像学表现可能与骨转移相似,需要综合评价。多学科协作在实现准确诊断方面起着至关重要的作用。提高对棕色肿瘤作为骨转移的潜在模拟物的认识可能有助于防止误诊,并确保对伴有甲状旁腺功能亢进的溶骨性骨病变的患者进行最佳护理。