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The X-ray showed a 5 cm multiloculated mass with slightly blurred edges in the distal left femoral shaft (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). The magnetic resonance image showed a heterogeneous lytic mass at the distal femur (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). A tumor biopsy was performed, revealing abundant eosinophilic and multinucleated giant cells, suggesting a giant cell granuloma or a brown tumour. The analytical study revealed a total serum calcium 10.9 mg/dl (normal range [NR] 8.5–10.5), phosphataemia 2.3 mg/dl (NR 2.5–4.5), PTH value of 324 pg/ml (NR 15–65). With the diagnosis of primary hyperparathyroidism, a Tc-99m-Sestamibi scintigraphy showed a parathyroid adenoma of the lower right pole and abnormal uptake in the distal internal left femur (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). A CT scan of the neck and chest showed a right paratracheal adenoma of 35 × 16 mm. The left inferior parathyroid adenoma was resected without complications. The pathological study confirmed the diagnosis. Six months later the analytical parameters normalized and the scintigraphy showed that the mass had disappeared (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). It is interesting to highlight that bone images may disappear once the primary hyperparathyroidism has healed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mintegui G, Mendoza B. Regresión de tumor pardo en adenoma paratiroideo. Med Clin (Barc). 2020;155:519.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 874 "Ancho" => 1667 "Tamanyo" => 143492 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 700 "Ancho" => 1667 "Tamanyo" => 129981 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015500000011/v1_202012152105/S2387020620305210/v1_202012152105/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015500000011/v1_202012152105/S2387020620305210/v1_202012152105/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620305210?idApp=UINPBA00004N" ]
Journal Information
Vol. 155. Issue 11.
Pages 519 (December 2020)
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Vol. 155. Issue 11.
Pages 519 (December 2020)
Image in medicine
Brown tumor regression in parathyroid adenoma
Regresión de tumor pardo en adenoma paratiroideo
Clínica de Endocrinología y Metabolismo, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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