Isolated bone lesion secondary to hyperparathyroidism: diagnostic considerations

Area of Science:

• Endocrinology
• Orthopedic Surgery
• Pathology

Background:

• Brown tumours are benign bone lesions resulting from secondary hyperparathyroidism.
• Accurate diagnosis is crucial for appropriate treatment and patient outcomes.

Observation:

• Two cases of bone lesions secondary to hyperparathyroidism were initially misdiagnosed.
• The first case, a femoral lesion, was misdiagnosed as an aneurysmal cyst.
• The second case, a humeral lesion, was misdiagnosed as a giant cell tumour.

Findings:

• Incisional biopsies led to incorrect initial diagnoses in both cases.
• Delayed diagnosis in the first case revealed multiple tibial brown tumours after initial femoral lesion treatment.
• The second case was correctly diagnosed as a brown tumour secondary to hyperparathyroidism based on clinical history and lab analysis.

Implications:

• Incisional biopsies alone may be insufficient for diagnosing brown tumours.
• A comprehensive diagnostic approach, integrating clinical, laboratory, and imaging data, is essential.
• Correctly diagnosing brown tumours prevents inadequate treatments and improves patient quality of life.