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[Multiple brown tumours in a patient with tertiary hyperparathyroidism]
V Pino Rivero1, A González Palomino, G Trinidad Ruiz
1Facultativo Especialista de Otorrinolaringología, Complejo Hospitalario Infanta Cristina, Badajoz. vicentepinorivero@terra.com
Anales Otorrinolaringologicos Ibero-Americanos
|September 15, 2005
Summary
Tertiary hyperparathyroidism persisted post-kidney transplant, causing brown tumors. Surgical removal of a parathyroid adenoma resolved bone issues and lithiasis.
Area of Science:
- Nephrology
- Endocrinology
- Skeletal Radiology
Background:
- Secondary hyperparathyroidism is a common complication of chronic renal failure.
- Persistent secondary hyperparathyroidism can progress to tertiary hyperparathyroidism, even after kidney transplantation.
- Autonomous parathyroid function necessitates specific management strategies.
Observation:
- A 49-year-old female presented with persistent hyperparathyroidism and skeletal manifestations (brown tumors) after a kidney transplant.
- Radiographic imaging (X-rays and CT) confirmed multiple brown tumors in the iliac bones and tibia.
- The patient exhibited osteoarticular symptoms and lithiasis attributed to tertiary hyperparathyroidism.
Findings:
- Surgical parathyroidectomy successfully removed a parathyroid adenoma.
- Histological examination confirmed the adenoma's nature.
- Post-surgery, the patient experienced significant improvement in osteoarticular manifestations and resolution of lithiasis.
Implications:
- Parathyroidectomy is an effective treatment for tertiary hyperparathyroidism with symptomatic brown tumors.
- Early diagnosis and intervention can prevent severe skeletal complications.
- Careful postoperative monitoring is crucial, even in the absence of immediate complications like hypocalcemia.