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J Korean Neurosurg Soc. 2015 Oct;58(4):389-392. English. Case Report. https://doi.org/10.3340/jkns.2015.58.4.389
Sonmez E , Tezcaner T , Coven I , Terzi A .
Department of Neurosurgery, Baskent University School of Medicine, Ankara, Turkey. erkinso@gmail.com
Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey.
Department of Neurosurgery, Baskent University Konya Training and Research Hospital, Konya, Turkey.
Department of Pathology, Baskent University School of Medicine, Ankara, Turkey.
Abstract

Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

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