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LETTER TO EDITOR
Year : 2010  |  Volume : 58  |  Issue : 3  |  Page : 487-488

Bumps on the head: Brown tumors of hyperparathyroidism


1 Department of Radiology, Fortis Hospital, Sector 62, Phase 8, Mohali - 160 062, Punjab, India
2 Department of Neurosurgery, Fortis Hospital, Sector 62, Phase 8, Mohali - 160 062, Punjab, India

Date of Acceptance08-Jun-2010
Date of Web Publication17-Jul-2010

Correspondence Address:
Rahat Brar
Department of Radiology, Fortis Hospital, Sector 62, Phase 8, Mohali - 160 062, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.65518

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How to cite this article:
Brar R, Prasad A, Chawla R, Sharma T. Bumps on the head: Brown tumors of hyperparathyroidism. Neurol India 2010;58:487-8

How to cite this URL:
Brar R, Prasad A, Chawla R, Sharma T. Bumps on the head: Brown tumors of hyperparathyroidism. Neurol India [serial online] 2010 [cited 2019 Sep 18];58:487-8. Available from: http://www.neurologyindia.com/text.asp?2010/58/3/487/65518


Sir,

A 28-year-old previously healthy woman presented with a 1-year history of progressively increasing hard swellings on her head with headaches. On initial examination, she had multiple bony swellings on the scalp. Neurologic examination was normal. Computerized tomography scan of the head revealed multiple well-defined expansile, lytic calvarial lesions involving the bilateral frontal and parietal bones. [Figure 1], [Figure 2], [Figure 3] The biochemical parameters, including serum calcium (14.9 mg/dL [normal, 8-10.5 mg/dL]), alkaline phosphatase (825 U/L [normal, 30-120 U/L]), serum parathyroid hormone (PTH; 1260 pg/L [normal, 10-60 pg/mL]) were raised. She had low levels of inorganic phosphorus (2.2 mg/dL [normal, 3.0-4.5 mg/dL]).

Ultrasound neck revealed a 6 Χ 8 Χ 3 mm hypoechoic lesion on the right side near the posteroinferior surface of the thyroid gland. Fine-needle aspiration cytology confirmed the diagnosis of a parathyroid adenoma. The patient underwent surgery and a right lower parathyroidectomy was performed. In the same sitting, biopsy from the frontal skull swelling was done. Pathologic examination confirmed the diagnosis of osteitis fibrosa cystica (brown tumor of hyperparathyroidism). After surgery, the serum PTH (49 pg/mL) and serum calcium (10.3 mg/dL) returned to normal.

Brown tumors of the skull, facial bones, and the orbits are not uncommon. [1],[2] The patient usually presents with symptoms of compression of the nearby structures.

 
  References Top

1.Goswami P, Sarma PK, Sethi S, Hazarika S. Skeletal manifestations in a case of primary hyperparathyroidism caused by parathyroid adenoma. Indian J Radiol Imaging 2002;12:267-70.  Back to cited text no. 1    Medknow Journal  
2.Yilmazlar S, Arslan E, Aksoy K, Tolunay S. Sellar-parasellar brown tumor: Case report and review of literature. Skull Base 2004;14:163-8.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  


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  [Figure 1], [Figure 2], [Figure 3]



 

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Online since 20th March '04
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