Sonmez Erkin, Tezcaner Tugan, Coven Ilker, Terzi Aysen
Department of Neurosurgery, Baskent University School of Medicine, Ankara, Turkey.
Department of General Surgery, Baskent University School of Medicine, Ankara, Turkey.
J Korean Neurosurg Soc. 2015 Oct;58(4):389-92. doi: 10.3340/jkns.2015.58.4.389. Epub 2015 Oct 30.
Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.
棕色瘤也称为破骨细胞瘤，是一种罕见的非肿瘤性病变，发生于原发性或继发性甲状旁腺功能亢进的情况下。甲状旁腺腺瘤或增生是原发性甲状旁腺功能亢进中棕色瘤的主要来源，而慢性肾衰竭是继发性甲状旁腺功能亢进的主要原因。大多数诊断为原发性甲状旁腺功能亢进的患者表现为肾结石或孤立性高钙血症。然而，近三分之一的患者无症状，高钙血症是偶然发现的。在甲状旁腺功能亢进的晚期可见骨骼受累，如全身性骨质减少、骨吸收、骨囊肿和棕色瘤。根据其位置，症状包括轴向疼痛、神经根病、脊髓病和脊髓神经根病。在棕色瘤的鉴别诊断中应排除浆细胞瘤、淋巴瘤、巨细胞瘤和转移瘤。棕色瘤的治疗包括甲状旁腺功能亢进的管理和神经减压。作者报告了一例非常罕见的脊柱棕色瘤病例，它作为原发性甲状旁腺功能亢进的初始表现导致急性截瘫。
