Osteitis Fibrosa Cystica Mistaken for Malignant Disease

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 sug...

Full description

Bibliographic Details
Main Authors: Ja Hyun Lee, Sung Min Chung, Han Su Kim
Format: Article
Language:English
Published: Korean Society of Otorhinolaryngology-Head and Neck Surgery 2013-06-01
Series:Clinical and Experimental Otorhinolaryngology
Subjects:
Online Access:http://www.e-ceo.org/upload/pdf/ceo-6-110.pdf
id doaj-dccf5ea118cd4473a3cfa62008c9c160
record_format Article
spelling doaj-dccf5ea118cd4473a3cfa62008c9c1602020-11-24T21:15:43ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202013-06-016211011310.3342/ceo.2013.6.2.110232Osteitis Fibrosa Cystica Mistaken for Malignant DiseaseJa Hyun Lee0Sung Min Chung1Han Su Kim2Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.Department of Otolaryngology and Head & Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea.Department of Otolaryngology and Head & Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea.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.http://www.e-ceo.org/upload/pdf/ceo-6-110.pdfHyperparathyroidismOsteitis fibrosa cysticaBrown tumor
collection DOAJ
language English
format Article
sources DOAJ
author Ja Hyun Lee
Sung Min Chung
Han Su Kim
spellingShingle Ja Hyun Lee
Sung Min Chung
Han Su Kim
Osteitis Fibrosa Cystica Mistaken for Malignant Disease
Clinical and Experimental Otorhinolaryngology
Hyperparathyroidism
Osteitis fibrosa cystica
Brown tumor
author_facet Ja Hyun Lee
Sung Min Chung
Han Su Kim
author_sort Ja Hyun Lee
title Osteitis Fibrosa Cystica Mistaken for Malignant Disease
title_short Osteitis Fibrosa Cystica Mistaken for Malignant Disease
title_full Osteitis Fibrosa Cystica Mistaken for Malignant Disease
title_fullStr Osteitis Fibrosa Cystica Mistaken for Malignant Disease
title_full_unstemmed Osteitis Fibrosa Cystica Mistaken for Malignant Disease
title_sort osteitis fibrosa cystica mistaken for malignant disease
publisher Korean Society of Otorhinolaryngology-Head and Neck Surgery
series Clinical and Experimental Otorhinolaryngology
issn 1976-8710
2005-0720
publishDate 2013-06-01
description 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.
topic Hyperparathyroidism
Osteitis fibrosa cystica
Brown tumor
url http://www.e-ceo.org/upload/pdf/ceo-6-110.pdf
work_keys_str_mv AT jahyunlee osteitisfibrosacysticamistakenformalignantdisease
AT sungminchung osteitisfibrosacysticamistakenformalignantdisease
AT hansukim osteitisfibrosacysticamistakenformalignantdisease
_version_ 1716744346608336896