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Multiple Brown Tumors of the Ribs in a Patient With Secondary Hyperparathyroidism Due to Chronic Renal Failure FREE TO VIEW

Mustafa Calik, MD; Saniye Calik, MD; Mihrican Yesildag, MD; Taha Bekci, MD
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Konya Education and Research Hospital, Konya, Turkey

Chest. 2015;148(4_MeetingAbstracts):655A. doi:10.1378/chest.2278282
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SESSION TITLE: Miscellaneous Global Case Reports

SESSION TYPE: Global Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: A "Brown Tumour” (BT) is not real a neoplasm but associated with special type of reactive benign cellular processes so-called tumour-like lesion due to secondary hyperparathyroidism (HPT) in patient with chronic renal failure (CRF) whose ranges from 1.5% to more than 13%. Although it could be found in any bone most commonly localised in long bones, pelvis, clavicle, ribs and the mandible. BT usually affects woman in the third to fourth decades of their life [1,2]. We aim to highlight a rare case of multiple BT of the ribs in a patient with secondary HPT due to CRF

CASE PRESENTATION: A 33-year-old man had been receiving haemodialysis (three sessions of 4 hours per week) for 14 years. He was referred to our clinic for suspicion of tuberculosis. His physical and radiological examination were revealed multiple tumours in the chest wall (Figure ****). During follow-up, conservative treatment had failed and his hypercalcemia has worsened. He underwent subtotal parathyroidectomy and diagnosed as parathyroid hyperplasia. After the surgery, calcium and PTH level gradually decreased. He was discharged on third postoperative day without any complaints.

DISCUSSION: Multiple BTs one of the serious complications of CRF is extremely infrequent due to preventive treatment of Phosphate binders and vitamin D; and routine screening of hypercalcemia and early diagnosis of hyperparathyroidism [3].

CONCLUSIONS: Total or subtotal parathyroidectomy should be considered as a treatment option because of the short recovery time especially in patients who have failed preventive therapy.

Reference #1: Karagoz A, Turkmen K, Yazici R, Arslan S, Baktık S, Karanis MI, Altintepe L, Guney An exceedingly rare localization of a brown tumor in a hemodialysis patient. I Hemodial Int. 2013 Oct;17(4):660-3.

Reference #2: Fatma LB, Barbouch S, Fethi BH, Imen BA, Karima K, Imed H, Fethi el Y, Fatma BM, Rim G, Taieb BA, Maiz HB, Adel K. Brown tumors in patients with chronic renal failure and secondary hyperparathyroidism: report of 12 cases. Saudi J Kidney Dis Transpl. 2010 Jul;21(4):772-7.

Reference #3: Sato M, Kobayashi T, Dobashi H, Ohye H, Matsubara S, Murao K, Miyauchi A, Kobayashi S, Takahara J. Large goiter and multiple rib tumors. Endocrine. 2000 Feb;12(1):11-4

DISCLOSURE: The following authors have nothing to disclose: Mustafa Calik, Saniye Calik, Mihrican Yesildag, Taha Bekci

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