Brown Tumour


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A hyperparathyroidism-induced tumour-like mass of bony tissue characterised by fibrosis, cyst formation, marked osteoclastic resorption, multinucleated giant cells, and hemosiderin—which imparts the brown color deposits and rounded, cyst-like radiologic defects; brown tumours also occur in 2º hyperparathyroidism and may be the first sign of renal osteodystrophy in patients with ESRD who are kept alive by renal dialysis, and have enough time to develop the osseous reaction
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Skeletal radiography revealed splaying of lower limb below the knee joint, decreased bone mineral density, thin cortices and several cystic brown tumours in pelvis and calvarium presenting the initiation of von Recklinghausen disease of bone (Figure-1).
A specialist endocrinology opinion was that this was a picture of simple vitamin D deficiency, unrelated to the lesion in the maxilla, as the results of the parathyroid immunoassay were not considered deranged enough to be consistent with a Brown tumour.
Brown tumours Mandible, clavicle, ribs, pelvis, long bones and hands 4.
Based on these results, the osteolytic FDG avid bone lesions were classified as multiple brown tumours caused by primary hyperparathyroidism.
This case demonstrates that increased FDG uptake in clinically occult brown tumours can be misleading in the evaluation of a patient for malignancy.
Brown tumours of bone or osteoclastomata are highly vascular, lytic bone lesions representing a reparative cellular process rather than a neoplastic process usually seen in patients with hyperparathyroidism with hypercalcaemia.
Brown tumours exhibit no pathognomonic histological changes.
Brown tumours show a high accumulation of FDG, probably as a result of the presence of giant cells.
Brown tumours represent a reparative cellular process rather than a neoplastic process that shows lytic lesions.