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Brown tumors in dialyzed patients with secondary hyperparathyroidism: Report of 16 cases
Author(s) -
Hamouda Mouna,
Handous Insaf,
Dhia Nasr Ben,
Ayachi Samia,
Letaief Ahmed,
Aloui Sabra,
Frih Ammeur,
Skhiri Habib,
Khochtali Habib,
Elmay Mezri
Publication year - 2012
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2012.00695.x
Subject(s) - medicine , secondary hyperparathyroidism , parathyroidectomy , surgery , dialysis , renal osteodystrophy , hyperparathyroidism , radiological weapon , hemodialysis , refractory (planetary science) , retrospective cohort study , stage (stratigraphy) , osteodystrophy , end stage renal disease , parathyroid hormone , radiology , kidney disease , paleontology , physics , astrobiology , biology , calcium
Brown tumors ( BTs ) are relatively uncommon but they are serious complications of renal osteodystrophy. The objective of this study was to analyze the clinical, biological, and radiological characteristics of 16 patients with BTs provoked by secondary hyperparathyroidism (s HPT ) and its response to the decrease in parathyroid hormone levels after parathyroidectomy ( PTX ). The management of that uncommon condition was also reviewed. We conducted a retrospective study including 16 end‐stage renal disease patients who underwent subtotal PTX between 1997 and 2007 for severe s HPT with BTs . Our study included 10 men and 6 women, whose average age was 34 years. All patients were on dialysis. Ten of them were on dialysis for more than 5 years. The median duration on dialysis was 84 months. Patients included suffered from swellings associated with functional limitations. BTs had multiple locations in 7 patients. Jaw was the most frequent location (62%). Radiography and tomodensitometry demonstrated a mixed radio lucent and radio‐opaque lesions with an expansion of the cortical bone. Bone scan demonstrated an increased uptake of lesions. Chirurgical treatment was indicated in all cases because of severe refractory s HPT with functional limitations and/or disfiguring deformities. In all cases, BTs stopped its progression and even decreased in size. However, it was insufficient in four cases, which required a surgical resection. PTX remains an efficacious approach in resistant cases of s HPT with persistent BTs .