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.