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Giant cell tumor of bone in a patient with diagnosis of primary hyperparathyroidism: a challenge in differential diagnosis with brown tumor

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Abstract

Giant cell lesions of bone share similar clinical, radiological, and histological features. The most challenging differential diagnosis is between giant cell tumor (GCT) and brown tumor (BT) secondary to hyperparathyroidism. Differential diagnosis is based on determining serum calcium concentration and other markers of calcium metabolism. The authors present the unusual case of a 37-year-old Caucasian woman affected by a GCT of the proximal left tibia and concomitant asymptomatic primary hyperparathyroidism (PHPT) due to a parathyroid adenoma. The presence of two concurrent diseases complicated diagnosis and relative treatment. The patient was first treated for the adenoma, then after 9 months, she underwent curettage of tibial GCT. Denosumab treatment was administered for 12 months to control a relapse occurring at 15 months post-curettage. At 32-month follow-up from primary tibial surgery, the patient was free from tumor disease. To our knowledge, this is the first case in the literature reporting the concomitant presence of asymptomatic PHPT and GCT. The possibility of concomitant finding these two diseases has to be considered during the decision-making process.

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Conflict of interest

The authors declare that they have no conflicts of interest or financial support sponsoring this research.

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Authors and Affiliations

  1. Department of Oncological Orthopaedics, IFO - Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy

    Barbara Rossi & Carmine Zoccali

  2. Department of Oncology, IFO - Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy

    Virginia Ferraresi

  3. Department of Endocrinology, IFO - Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144, Rome, Italy

    Maria Luisa Appetecchia

  4. Department of Pathology, “A. Gemelli” Hospital, Catholic University, 00138, Rome, Italy

    Mariangela Novello

Authors
  1. Barbara Rossi
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  2. Virginia Ferraresi
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  3. Maria Luisa Appetecchia
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  4. Mariangela Novello
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  5. Carmine Zoccali
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Corresponding author

Correspondence to Barbara Rossi.

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Rossi, B., Ferraresi, V., Appetecchia, M.L. et al. Giant cell tumor of bone in a patient with diagnosis of primary hyperparathyroidism: a challenge in differential diagnosis with brown tumor. Skeletal Radiol 43, 693–697 (2014). https://doi.org/10.1007/s00256-013-1770-9

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  • DOI: https://doi.org/10.1007/s00256-013-1770-9

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