Simon Isabelle, Gevenois Pierre Alain, Del Marmol Véronique, El Kazzi Wissam, Trepant Anne-Laure, Gastaldello Karine, Nortier Joëlle L
Department of Nephrology, Université Libre de Bruxelles, Brussels, Belgium.
Case Rep Nephrol Urol. 2012 Jul;2(2):152-7. doi: 10.1159/000345281. Epub 2012 Nov 8.
Pyogenic granuloma is a benign vascular tumor of the skin or mucosae usually observed after irritative processes. We report the case of a non-compliant hemodialysis patient with severe hyperparathyroidism who rapidly developed growing pyogenic granuloma of the distal part of the left thumb. This tumor mimicked sarcoma and caused recurrent bleeding during hemodialysis sessions. Hand radiograph revealed an osteolytic lesion compatible with a brown tumor. Among other brown tumors, several of those found in the ribs were responsible of a severe respiratory restrictive deficit. This report highlights the difficulty to choose the adequate treatment of severe hyperparathyroidism, and discusses the benefit/risk balance of performing parathyroidectomy.
化脓性肉芽肿是一种通常在刺激过程后出现的皮肤或黏膜良性血管肿瘤。我们报告了一例不配合治疗的血液透析患者，该患者患有严重甲状旁腺功能亢进，左拇指远端迅速出现生长性化脓性肉芽肿。这种肿瘤类似肉瘤，在血液透析过程中反复出血。手部X线片显示溶骨性病变，符合棕色瘤表现。在其他棕色瘤中，肋骨处发现的几个棕色瘤导致了严重的呼吸限制性缺陷。本报告强调了选择合适治疗严重甲状旁腺功能亢进的困难，并讨论了甲状旁腺切除术的获益/风险平衡。
