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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Primary hyperparathyroidism. A rare cause of spinal cord compression
Fares H Haddad1, Omar M Malkawi, Amer A Sharbaji
1Department of Medicine, King Hussein Medical Center, Amman, Jordan. Haddf@hotmail.com
Saudi Medical Journal
|April 26, 2007
Summary
A rare case of aggressive brown tumors in primary hyperparathyroidism (PHPT) mimicking metastasis highlights the importance of screening osteoporosis patients for secondary causes. Early diagnosis and treatment of parathyroid adenoma led to significant clinical improvement.
Area of Science:
- Endocrinology
- Oncology
- Orthopedics
Background:
- Osteoporosis management with calcium and Vitamin D can mask underlying primary hyperparathyroidism (PHPT).
- PHPT can present with severe complications, including brown tumors and spinal cord compression.
- Differentiating brown tumors from metastatic bone lesions is crucial for appropriate patient management.
Observation:
- A 62-year-old woman with osteoporosis developed progressive lower limb weakness and paresthesia.
- Investigations revealed elevated parathyroid hormone, calcium, and low phosphorus, alongside multiple bone lesions suggestive of metastasis.
- Imaging confirmed a parathyroid adenoma and brown tumors in the ribs and spine, causing cord compression.
Findings:
- Surgical decompression and parathyroidectomy resulted in remarkable clinical improvement and regression of bony lesions.
- Histopathology confirmed brown tumors in the rib and spine, secondary to PHPT.
- This case underscores the potential for aggressive presentation of brown tumors in PHPT.
Implications:
- Physicians should consider screening for PHPT in osteoporosis patients, especially those with unexplained bone lesions or neurological symptoms.
- Prompt diagnosis and treatment of parathyroid adenoma are essential to prevent severe complications like spinal cord compression.
- Recognizing the association between PHPT and multiple brown tumors can prevent misdiagnosis as metastatic disease.
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