Nagaraj Chandana, Oommen Regi, Jacob Paul M, Irodi Aparna
Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Nucl Med. 2012 Apr;27(2):107-10. doi: 10.4103/0972-3919.110700.
Parathyroid adenoma is the most common cause of primary hyperparathyroidism. Severe cases of primary hyperparathyroidism manifest as osteitis fibrosa cystica generalisata, characterized by generalized bone loss with increased bone resorption, including both subperiosteal and endosteal surfaces. The most common sites for formation of fibrotic cystic lesions (brown tumors) are in the long bones and jaw which present as swelling, pathological fracture, and/or bone pain, usually involving multiple sites. Here, we describe an unusual presentation of a solitary brown tumor in a young male who initially presented to the hand surgeon with a history of right thumb swelling following trivial trauma. Further detailed clinical, biochemical, scintigraphic (Tc 99m methylene diphosphonate scintigraphy and Tc 99m Sestamibi scintigraphy), and radiological investigations aided definitive diagnosis and treatment. The causative parathyroid adenoma was excised curing hyperparathyroidism and the lesion regressed substantially.
甲状旁腺腺瘤是原发性甲状旁腺功能亢进最常见的病因。原发性甲状旁腺功能亢进的严重病例表现为全身性纤维囊性骨炎，其特征是全身骨质流失，骨吸收增加，包括骨膜下和骨内膜表面。纤维囊性病变（棕色瘤）最常见的形成部位是长骨和颌骨，表现为肿胀、病理性骨折和/或骨痛，通常累及多个部位。在此，我们描述了一名年轻男性孤立性棕色瘤的不寻常表现，该患者最初因轻微创伤后右拇指肿胀的病史就诊于手外科医生。进一步详细的临床、生化、闪烁扫描（锝99m亚甲基二膦酸盐闪烁扫描和锝99m甲氧基异丁基异腈闪烁扫描）及放射学检查有助于明确诊断和治疗。切除致病的甲状旁腺腺瘤治愈了甲状旁腺功能亢进，病变也大幅消退。
