Background Brown tumors are unusual but serious complications of renal osteodystrophy. This unusual complication of secondary hyperparathyroidism (HPT) is more commonly seen with increased longevity of hemodialysis patients and can be found in any bone
Objectives We retrospectively studied 12 patients presenting with chronic renal failure and brown tumor related to secondary hyperparathyroidism
Methods The purpose of this study is to analyze clinical, biologic and radiologic characteristics of brown tumors in our patients
Results Eleven patients were on chronic hemodialysis and 1 case was chronic renal failure. The median duration between renal failure and end stage renal failure was 36 months (range: 12-190 months) and the median duration in dialysis for 11 cases: 92 months (range: 72-252 months). The bone pain was noted in all cases (100%), pathological fracture in one case (8%) and a palpable bone tumor in 10 cases (83%). Elevated serum calcium (> 2.35 mmol/L) was noted in four cases (33%), elevated serum Phosphate (> 1.78 mmol/L) in ten cases (80%), elevated serum alkaline phosphate (> 290 UI/L) in all cases and intact PTH was > 300 pg/mL in all cases with a serum median rate at 1475 pg/mL (range: 682-3687 pg/L). Subtotal parathyroidectomy was performed in all cases with a resultant decrease in size of brown tumors.
Conclusions Phosphate binders and vitamin D are useful preventive measures of secondary HPT and brown tumors. Radiological bone evaluation is need to diagnosis asymptomatic brown tumors. Parathyroidectomy remains the first choice treatment leads often in a decrease of size of brown tumors. Remaining tumor mass may need sometimes local surgical removal after parathyroidectomy.
Disclosure of Interest None Declared