Multiple Brown Tumors Mimicking Bone Metastasis: A Case Report

Received 8/4/2010; revised 8/24/2010; accepted 9/2/2010. For correspondence and reprints contact: Yum-Kung Chu, M.D., Department of Nuclear Medicine, Taipei Veterans General Hospital. 201 Section 2, Shih-Pai Road, Taipei 11217, Taiwan. Tel: (886)2-28757301, E-mail: [email protected] Brown tumors are tumors of bone that arise in settings of excess osteoclast activity and will cause bone pain when the periosteum is involved. A case of multiple brown tumors is reported. The patient presented with multiple bone pain. Plain radiographs, computed tomography and magnetic resonance imaging demonstrated multiple lytic lesions of the skeleton and a TcMDP bone scan depicted multiple areas of increased uptake. All of these findings implicated multiple bone metastases. The pathology of femoral lesion revealed giant cell tumor of hyperparathyroidism (brown tumor). The patient underwent a resection of the parathyroid adenoma afterward. His symptom relieved while calcium normalized subsequently. After 5 years, Tc-MDP bone scan demonstrated amelioration of most lesions. We conclude that, in patients with similar findings of metastases of skeleton should be carefully re-evaluated for the presence of biochemical anomalies.