Management of brown tumor of spine with primary hyperparathyroidism: A case report and literature review.

RATIONALE: Brown tumor (BT) is a rare benign lesion in skeletal system. It is especially rare secondary to primary hyperparathyroidism (HPT). The differential diagnosis can be misleading due to its diversified clinical characteristics. Final diagnosis mainly relies on excessive elevated parathyroid hormone and biopsy. Treatments include surgical interventions and drugs. Only 19 articles (total 22 cases) reported BT of spine caused by primary HPT.

PATIENT CONCERNS: A 50-year-old woman was admitted to our hospital complaining left elbow and thoracodorsal pain with the lower limbs weakness.

DIAGNOSES: Multifocal BT.

INTERVENTIONS: The patient received intramuscular injection of Miacalcic and incense of Calcitonin (Salmon) Nasal Spray to decrease serum calcium level. Surgery was performed later to excise the ectopia parathyroidoma.

OUTCOMES: At 1-year follow-up, the patient was able to lead an independent life in her full capacity, even though she occasionally complained mild weakness of lower limbs.

LESSONS: BT of spine with HPT is rarely seen in the clinical practice. Treating the primary parathyroid diseases can be effective. For patients with vertebral fractures and neural deficits, immediately surgical intervention will be necessary to prevent the worse of neurological function.