Brown tumor in patients with secondary hyperparathyroidism due to chronic renal failure: a case series study.

Abstract

Brown tumor (BT) is an un-common benign bone lesion caused by hyperparathyroidism. Occurrence of BT in sitting of chronic renal failure is considered as sever form of renal- osteodystrophy. Prevalence of BT is (1.5-13%) among dialysis patient. The definite diagnosis of BT is by histopathology. However, BT can be diagnosed noninvasively by using lab and imaging-based criteria. The most frequent sites: ribs, clavicles, extremities, pelvis and facial bones. Although no malignant potential for BT, it can result in catastrophic complications if not treated. Unfortunately, no universal guideline management for BT. This necessitates recognition of clinical manifestation and imaging patterns of BT to be detected and managed properly. Aim of study: Describe the clinical features and the imaging patterns of BT among the studied population. A descriptive case series study was conducted in the central hospital of Al-Baida city /Libya from December 2021 to the end of March 2022, involved 3 hemodialysis male patients. The age ranges from 32-42 years. Parathyroid hormone level measured, Digital x-rays and Non-contrast CT-scan (chest, abdomen and pelvic) performed to all patients. All cases exhibited multifocal lesions located in spine, ribs, pelvic bone. Expansile lytic lesions found in 100% of cases. Some showed mixed solid and lytic lesions. None of studied cases received a proper pharmacological treatment, one case underwent decompressive surgery. This humble case series shed light on the pattern of BT aiming for early discovering and proper management. The findings of this study can be used as baseline for further research in future.