“Brown Tumor” of Hyperparathyroidism

Abstract

In the general frame of primary, secondary, or tertiary hyperparathyroidism, “brown tumor” describes localized, destructive cyst-like areas in the skeleton, due to osteoclast resorption. The lesions are more frequent in females, with the highest incidence between the third and sixth decades. They are most common in tubular bones of the extremities and the maxillary bones, but the lesions may involve any skeletal bone and may be solitary or multiple. Radiologically, lesions are osteolytic, with undefined margins. Histologically, the bone marrow is replaced by a loose, richly vascularized connective tissue. The remaining cancellous bone shows increased osteoclastic activity. Hemorrhage and abundant hemosiderin pigment deposits are present. The most common differential diagnosis is a giant cell tumor of the bone. In patients with hyperfunctioning parathyroid (adenoma or hyperplastic glands), surgical treatment tends to reduce the osteoclastic activity.

Eduardo Santini-Araujo was deceased at the time of publication.