Brown tumor

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[edit] Discussion

  • Brown tumors represent a reparative cellular process rather than a neoplastic process.
  • In chronic renal disease, continual, excessive urinary calcium excretion can lower the serum calcium level and lead to a rise in parathonmone secretion so that skeletal calcium can be mobilized to maintain normal serum calcium levels.
  • This mobilization occurs through rapid osteoclastic turnover of bone, a direct effect of

parathormone on bone.

  • In localized regions where bone loss is particularly rapid, hemorrhage, reparative granulation tissue,

and active, vascular, proliferating fibrous tissue may replace the normal marrow contents, resulting in a brown tumor.

  • Hemosidenin imparts the brown color.
  • Brown tumors have a slightly greater frequency in primary hyperparathyroidism than in secondary hyperparathyroidism (3% vs 2%). However, secondary hyperparathyroidism is much more common than primary hypenparathyroidism so that most brown tumors are associated with secondary hyperparathyroidism.

[edit] Imaging Findings

[edit] Plain film

  • Well-defined, purely lytic lesions that provoke little reactive bone. The cortex may be thinned and expanded, but will not be penetrated.

[edit] CT

  • Attenuation values on CT will be in the range of blood and fibrous tissue.

[edit] Angiography

  • Hypervascular.

[edit] Bone scan

  • Intensely uptake.

[edit] Images

Patient #1: Hip pain in a patient with hyperparathyroidism

[edit] See Also

[edit] External Links

Goldminer: Brown tumor

[edit] References

  • Chew, FS, Huang-Hellinger, F. Brown tumor. Am. J. Roentgenol. 1993 160: 752

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