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• TITLE: Diagnostic dilemma: metastatic bone malignancy or primary hyperparathyroidism with brown tumor

  AUTHORS: Esra Hatipoglu, Ahmet Emre Eskazan, Ozlem Celik, Fatih Kantarci, Pinar Kadioglu

  KEYWORDS: Brown Tumor; Hyperparathyroidism; Metastatic Bone Disease

  JOURNAL NAME: Open Journal of Internal Medicine, Vol.3 No.2, May 31, 2013

  ABSTRACT: Multiple osteolytic lesions are usually associated with metastatic involvement of the bone. However metabolic bone diseases should also take their place in differential diagnosis. Here, we describe a primary hyperparathyroidism case with full-blown osteolytic lesions wich was diagnosed at first sight with having metastatic bone involvement. PET CT scan and laboratory results excluded a metastatic bone malignancy. Elevated serum calcium of 13.16 mg/dl, decreased serum phoshorus of 1.4 mg/dl and high intact-PTH level of 1054.7 pg/ml pointed out primary hyperparathyroidism. Sonographic examination revealed two adenomas of 2.9 × 3.3 mmand 3.3 ×2.7 mmin the left superior and right inferior parathyroid glands, respectively. Scintigraphy confirmed the presence of adenoma on the left.