Hip Pelvis.  2016 Sep;28(3):173-177. 10.5371/hp.2016.28.3.173.

Pathologic Fracture of the Femur in Brown Tumor Induced in Parathyroid Carcinoma: A Case Report

• Park SH
• Kong GM
• Kwon YU
• Park JH

• KMID: 2354550
• DOI: http://doi.org/10.5371/hp.2016.28.3.173

Abstract

Brown tumor refers to a change of skeletones that develops as a complication of hyperparathyroidism. As osteoclast is activated to stimulate reabsorption and fibrosis of bone, it causes a cystic change of the bone. Parathyroid carcinoma is being reported as a tumor that induces primary hyperparathyroidism. It causes excessive secretion of the parathyroid hormone and increases the blood parathyroid hormone and calcium. Bone deformation due to brown tumor is known to be naturally recovered through the treatment for hyperparathyroidism. However, there is no clearly defined treatment for lesions that can induce pathological fractures developing in lower extremities. We experienced a case where brown tumor developed in the proximal femur of a 57-year-old female patient due to parathyroid carcinoma. In this case, spontaneous fracture occurred without any trauma, and it was cured by performing intramedullary nailing fixation and parathyroidectomy. We report the treatment results along with a literature review.

Keyword

Femur; Fractures; Hyperparathyroidism; Osteitis fibrosa cystica

MeSH Terms

Calcium
Female
Femur*
Fibrosis
Fracture Fixation, Intramedullary
Fractures, Spontaneous*
Humans
Hyperparathyroidism
Hyperparathyroidism, Primary
Lower Extremity
Middle Aged
Osteitis Fibrosa Cystica
Osteoclasts
Parathyroid Hormone
Parathyroid Neoplasms*
Parathyroidectomy
Skeleton
Calcium
Parathyroid Hormone

Figure

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  Fig. 1 X-ray findings at the time of hospital visit. (A) Osteolytic lesion in right proximal femur and left femur were observed. On pelvis magnetic resonance image, the signal of brown tumor was low in T1WI (B) and high in T2WI (C).

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  Fig. 2 Fracture of right proximal femur occurred without trauma.

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  Fig. 3 The fracture on the right proximal femur was healed four months after the surgery.

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  Fig. 4 The final follow up X-ray shows healed fracture and improved multiple osteolytic lesion.

Reference

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