Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy.

Area of Science:

• Endocrinology
• Oncology
• Skeletal Biology

Background:

• Primary hyperparathyroidism involves excessive parathormone secretion, leading to bone resorption and potential skeletal complications.
• Brown tumors are rare fibrotic, cystic bony changes associated with hyperparathyroidism, occurring in less than 2% of patients.
• These lesions can present as multiple, lytic, expansile masses, posing diagnostic challenges.

Observation:

• A 23-year-old Indian woman presented with multiple lytic expansile bone lesions.
• Initial clinical suspicion leaned towards malignancy or fibrous dysplasia due to the nature of the lesions.
• The patient's evaluation ultimately revealed primary hyperparathyroidism as the underlying cause.

Findings:

• The presented case demonstrates a rare manifestation of primary hyperparathyroidism.
• Multiple Brown tumors, initially suspected as malignant neoplasms, were diagnosed.
• The differential diagnosis of lytic bone lesions must include endocrine disorders.

Implications:

• This case underscores the critical need for comprehensive differential diagnosis in patients with unexplained lytic bone lesions.
• Recognizing rare skeletal manifestations of endocrine diseases like primary hyperparathyroidism is crucial for accurate diagnosis and treatment.
• Early identification can prevent misdiagnosis and ensure appropriate management of hyperparathyroidism and its skeletal sequelae.