Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 19, 2015
Brown Tumor of Hyperparathyroidism
- Brown tumors (BT) are reactive osteolytic lesions caused by primary or secondary hyperparathyroidism.
- BT can occur as solitary or multiple lesions. The lesions may appear in any bone but are most frequently found in facial bones and jaws, sternum, pelvis, ribs and femur.
- Key Diagnostic Features
- Expansile lytic lesions
- The cortex may be thinned, fractured, or have a partial sclerotic rim.
- MR imaging findings are nonspecific and dependent on the relative proportion of tissue components.
- Hypointensity on T1WI, strong enhancement following contrast administration, and heterogeneous signal intensity on T2WI
- T2-shortening effect by hemosiderin and fluid-fluid levels have been described.
- DDx
- Metastases
- Epidermoid
- Multiple myeloma
- Leukemia
- Lymphoma
- Langerhans cell histiocytosis
- Rx: Management of hyperparathyroidism and, rarely, surgery
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