Ayşe Kevser DEMİR, Faruk KUTLUTÜRK, Serdar Savaş GÜL, Özge Gümüşay

Kemiğin dev hücreli tümörü taklit eden primer hiperparatiroidizme bağlı brown tümörü

Primer hiperparatiroidizm (PHP) parathormon seviyelerinin yüksekliği ile karakterize endokrin bir hastalıktır. Hiperparatiroidizm komplikasyonlarından biri olan Brown tümörü, osteoklastik aktivite sonucu ortaya çıkar ve iskelet sisteminde lezyonlar, patolojik kırık ve ağrıya sebep olabilir. Brown tümörü hem histopatolojik hem de radyolojik incelemelerde primer kemik tümörü, anevrizmal kemik kisti veya kemiğin dev hücreli tümörü ile karışabilir. Bu sunumda metastatik kemik tümöründen şüphelenilen ancak primer hiperparatroidi tanısı alan 50 yaşında bayan hastanın sunumu yapılmaktadır. Brown tümörleri benign karakterli lezyonlardır ama malign kemik hastalıklarını taklit edebilirler. Hastalığın ayırıcı tanısında klinik, histopatolojik ve radyolojik bulguların birlikte değerlendirilmelidir.

Anahtar Kelimeler:

Hiperparatiroidizm, Brown tümörü

Brown tumor caused by primary hyperparathyroidism mimicking giant cell tumor of bone

Primary hyperparathyroidism (PHP) is an endocrine disorder characterized by the elevation of parathormone levels. Brown tumor, one of the complications of hyperparathyroidism, is the result of osteoclastic activity resulting in lesions, pathological fractures and pain in the skeletal system. Brown tumor can be confused with primary bone tumor, aneurysmal bone cyst or giant cell tumor of bone in both histopathological and radiological examinations. In this presentation, a 50-year-old female patient with a suspicion of metastatic bone tumor but diagnosed with primary hyperparathyroidism is presented. Brown tumors are benign lesions, but they can mimic malign bone diseases. Clinical, histopathologic and radiological findings should be evaluated together in differential diagnosis of the disease.

Keywords:

Hyperparathyroidism, Brown tumor,

PDF

___

Referans 1. Gürlek A. Hiperkalsemi. Sözen T, Gogas DY, eds. Metabolik kemik hastalıkları. Türkiye Endokrinoloji ve Metabolizma Derneği, 2013. p. 6-12. ISBN: 978-605-4011-17-9
Referans 2. Cormier C, Souberbielle JC, Kahan A. Hyperparathyroidism and osteoporosis. Rev Med Interne. Rev Med Interne. 2004;25(Suppl 5):S560-7.
Referans 3. Su AW, Chen CF, Huang CK, Chen PC, Chen WM, Chen TH. Primary hyperparathyroidism with brown tumor mimicking metastatic bone malignancy. J Chin Med Assoc. 2010;73(3):177-80.
Referans 4. Ratner V, Dorfman HD. Giant-cell reparative granuloma of the hand and foot bones. Clin Orthop Relat Res. 1990;260:251-8.
Referans 5. Dinauer PA, Balingit AG, Rivera JE. Tc-99m sestamibiimaging of Brown tumors of primary hyperparathyroidism. Clin Nucl Med. 1996;21(3):192-6.
Referans 6. Proimos E, Chimona TS, Tamiolakis D, Tzanakakis MG, Papadakis CE. Brown tumor of the maxillary sinus in a patient with primary hyperparathyroidism: a casereport. J Med Case Rep. 2009 6;3:7495. doi: 10.4076/1752-1947-3-7495.
Referans 7. Resendiz-Colosia JA, Rodriguez-Cuevas SA, Flores-Diaz R, et al. Evolution of maxillofacial Brown tumors after parathyroidectomy in primary hyperparathyroidism. Head Neck. 2008;30(11):1497–504.
Referans 8. Gamelli RL, Liu H, He LK, Hofmann CA. Augmentations of glucose uptake and glucose transporter-1 in macrophages following thermal injury and sepsis in mice. J Leukoc Biol. 1996;59(5):639-47.
Referans 9. Rai S, Rattan V, Bhadada SK. Giant cell lesions associated with primary hyperparathyroidism. J Maxillofac Oral Surg. 2015;14(4):930–4.
Referans 10. Aghaghazvini L, Sharifian H, Rasuli B. Primary hyperparathyroidism misdiagnosed as giant cell bone tumor of maxillary sinus: a case report. Iran J Radiol. 2016;13: e13260. doi: 10.5812/iranjradiol.13260