Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

Overview

Journal J Bone Metab

Date 2020 Sep 10

PMID 32911586

Citations 5

Authors

Natalie Bransky

Neena Ramesh Iyer

Sophie Mestman Cannon

Alexander Hanlin Tyan

Praneet Mylavarapu

Ryan Orosco

David Brain Hom

Alan Ali Moazzam

Affiliations

Soon will be listed here.

Abstract

A 48-year-old woman in her 40's with end-stage renal disease and tertiary hyperparathyroidism (HPT) presented for a rapidly progressive maxillary tumor. Initial workup was notable for elevated intact parathyroid hormone (PTH) and diffuse thickening of skull and facial bones on computed tomography, and maxillary tumor biopsy with multinucleated giant cells. She underwent subtotal parathyroidectomy (with removal of a parathyroid adenoma and 2 hyperplastic glands) and partial resection of maxillary brown tumor. The patient's post-operative course was complicated by hungry bone syndrome, with hypocalcemia refractory to aggressive calcium repletion. Teriparatide (recombinant PTH) was utilized with rapid resolution of hypocalcemia. To our knowledge, this is the first case of maxillary brown tumor in tertiary HPT to be reported in the USA. This case also supports teriparatide as a novel therapeutic for hungry bone syndrome refractory to aggressive calcium repletion.

Citing Articles

Multiple fractures due to hungry bone syndrome following parathyroidectomy: a clinical case report and review of literature.

Tavakoli F, Yaghoubi F, Dalil D, Rezaei M Clin Diabetes Endocrinol. 2024; 10(1):25.

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Brown Tumors: The Hidden Face of Primary and Renal Hyperparathyroidism Amid Real-Life Settings.

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Forestalling Hungry Bone Syndrome after Parathyroidectomy in Patients with Primary and Renal Hyperparathyroidism.

Carsote M, Nistor C Diagnostics (Basel). 2023; 13(11).

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The value of integration of bone scan and targeted SPECT/CT in diagnosis of primary hyperparathyroidism with multiple bone brown tumor.

Sun L, Peng R Skeletal Radiol. 2023; 52(12):2505-2511.

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A Rare Presentation of a Bi-Maxillary Brown Tumour due to Secondary Hyperparathyroidism.

Cho-Fon C, Brian Ngokwe Z, Ines O Case Rep Dent. 2023; 2023:6180006.

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