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The Effect of Teriparatide in a Brown Tumor Patient With Pathological Hip Fracture: A Case Report and Literature
Dalia Abdel-Hadi1, Ali Al Lawati2, Ahmed Al Farkani3
1Department of Surgery, Orthopaedic division, Sultan Qaboos University Hospital, Muscat, Oman.
Case:
A 32-year-old man with end-stage renal disease (ESRD) from anti-neutrophil cytoplasmic antibody-associated vasculitis and tertiary hyperparathyroidism, presented with progressive right hip pain. A giant cell-rich lesion biopsy confirmed Brown tumor. Despite cinacalcet and vitamin D, hyperparathyroidism persisted, necessitating parathyroidectomy complicated by hungry bone syndrome and a pathological right hip fracture. Surgical fixation and prosthetic replacement were deferred due to high risk factors such as, ESRD and fracture pattern, as well as potential for postoperative implant failure and infection. Teriparatide was initiated to promote bone remodeling, leading to pain relief and radiographic improvement.
Conclusion:
To our knowledge, this is the first reported long-bone Brown tumor successfully treated with teriparatide.
