Srikantha Umesh, Hari Akshay, Lokanath Yadhu K, Mahesh D M
Department of Neurosurgery, Aster CMI Hospital, Bengaluru, Karnataka, India.
Department of Endocrinology, Aster CMI Hospital, Bengaluru, Karnataka, India.
J Craniovertebr Junction Spine. 2023 Jan-Mar;14(1):97-102. doi: 10.4103/jcvjs.jcvjs_144_22. Epub 2023 Mar 13.
"Brown tumors (BTs)" of the spine are benign rare lesions, seen in about 5%-13% of all patients with chronic hyperparathyroidism (HPT). They are not true neoplasms and are also known as osteitis fibrosa cystica or occasionally osteoclastoma. Radiological presentations are often misleading and may mimic other common lesions such as metastasis. A strong clinical suspicion is therefore necessary, especially in the background of chronic kidney disease with HPT and parathyroid adenoma. Surgical spinal fixation in case of instability due to pathological fracture may be required along with excision of the parathyroid adenoma being the treatment of choice, that maybe usually curative and carries a good prognosis. We would like to report one such rare case of BT involving the axis, or C2 vertebra, presenting with neck pain and weakness that was treated surgically. Only a few cases of spinal BTs have been reported so far in the literature. Involvement of cervical vertebrae and in particular C2 is rarer still with the one in this report only being the fourth such case.
脊柱“棕色瘤”（BTs）是一种罕见的良性病变，在所有慢性甲状旁腺功能亢进症（HPT）患者中约占5%-13%。它们并非真正的肿瘤，也被称为纤维囊性骨炎，偶尔也称为骨巨细胞瘤。放射学表现常常具有误导性，可能会与其他常见病变如转移瘤相混淆。因此，强烈的临床怀疑是必要的，尤其是在伴有HPT和甲状旁腺腺瘤的慢性肾病背景下。如果因病理性骨折导致不稳定，可能需要进行脊柱手术固定，同时切除甲状旁腺腺瘤是首选治疗方法，通常可能治愈且预后良好。我们在此报告一例罕见的累及枢椎（即C2椎体）的BT病例，该病例表现为颈部疼痛和无力，并接受了手术治疗。迄今为止，文献中仅报道了少数几例脊柱BTs病例。颈椎受累，尤其是C2受累更为罕见，本报告中的病例是第四例此类病例。
