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KMID : 1195620130060020110
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Clinical and Experimental Otorhinolaryngology
2013 Volume.6 No. 2 p.110 ~ p.113
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Osteitis Fibrosa Cystica Mistaken for Malignant Disease
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Lee Ja-Hyun
Chung Sung-Min
Kim Han-Su
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Abstract
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A 65-year-old man with back pain had plain radiographs that showed multiple osteolytic bone lesions of the pelvis, femur and L-spine; an magnetic resonance imaging scan of the L-spine showed extensive bony resorption with a posterior epidural mass involving the L1 spinous process; these findings suggested multiple myeloma or bony metastasis. However, all serology testing was negative. The parathyroid hormone and serum calcium levels were found to be abnormally elevated. A fine needle aspiration biopsy suggested that the L-spine lesion was consistent with the diagnosis of osteitis fibrosa cystica. A pathological fracture of the spine compressed the spinal cord, and surgical intervention was required. The neck computed tomography and Tc-99m sestamibi scan showed a solitary parathyroid mass. A minimally invasive parathyroidectomy using intraoperative parathyroid hormone monitoring was performed and two enlarged parathyroid glands identified. This case illustrates the importance of the consideration of a rare brown tumor associated with primary hyperparathyroidism in patients with the bone lesions suggestive of a malignancy.
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KEYWORD
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Hyperparathyroidism, Osteitis fibrosa cystica, Brown tumor
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