Multiple Brown Tumors in Parathyroid Carcinoma Mimicking Metastatic Bone Disease

An unusual case of multiple brown tumors due to parathyroid carcinoma is reported. The patient presented with lower leg pain. Plain radiographs demonstrated multiple lytic lesions of the lower legs and a Tc-99m MDP bone scan depicted multiple areas of increased uptake suggesting skeletal metastases....

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Bibliographic Details
Published in:Clinical nuclear medicine 1997-10, Vol.22 (10), p.691-694
Main Authors: PAI, MOONSUN, PARK, CHAN H, KIM, BYOUNG-SUCK, CHUNG, YOON-SOK, PARK, AND HEE-BOONG
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Bone Diseases - diagnostic imaging
Bone Diseases - etiology
Bone Neoplasms - diagnostic imaging
Bone Neoplasms - secondary
Carcinoma - complications
Carcinoma - diagnostic imaging
Carcinoma - secondary
Endocrinopathies
Female
Follow-Up Studies
Granuloma, Giant Cell - diagnostic imaging
Granuloma, Giant Cell - etiology
Humans
Hyperparathyroidism - diagnosis
Hyperparathyroidism - etiology
Leg
Malignant tumors
Medical sciences
Osteitis Fibrosa Cystica - diagnostic imaging
Osteitis Fibrosa Cystica - etiology
Parathyroid Hormone - blood
Parathyroid Neoplasms - complications
Parathyroidectomy
Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
Radionuclide Imaging
Radiopharmaceuticals
Technetium Tc 99m Medronate
Technetium Tc 99m Sestamibi
Thyroid Gland - diagnostic imaging
Thyroidectomy
Whole-Body Counting
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Summary:An unusual case of multiple brown tumors due to parathyroid carcinoma is reported. The patient presented with lower leg pain. Plain radiographs demonstrated multiple lytic lesions of the lower legs and a Tc-99m MDP bone scan depicted multiple areas of increased uptake suggesting skeletal metastases. Tc-99m sestamibi tumor scintigraphy showed multiple sites of tumor uptake in bones and a large area of increased uptake with a cystic component in the right lower pole of the thyroid gland. An open biopsy from the right tibial lesion revealed a brown tumor. A large parathyroid carcinoma with a necrotic cyst was removed. After parathyroidectomy and right thyroid lobectomy, the patient became free of bone pain and serum PTH levels normalized. A 9-month follow-up Tc-99m MDP bone scan demonstrated less intense uptake in the pelvis, tibia, and fibulae. Nine-month follow-up tumor imaging with Tc-99m MIBI revealed disappearance of the preoperative uptake of multiple brown tumor.
ISSN:0363-9762
1536-0229
DOI:10.1097/00003072-199710000-00006