Brown tumor of the orbit. Case report and review of the literature.

Brown tumors, focal bony lesions of hyperparathyroidism, result from the direct effect of parathyroid hormone on bone. While such lesions are not uncommon in primary hyperparathyroidism, brown tumors have been associated less frequently with secondary hyperparathyroidism and have rarely been described as involving the orbital bones. We have found only four such cases previously reported in the ophthalmic literature. We report a case of orbital involvement by brown tumor in a child with chronic renal failure and secondary hyperparathyroidism. Use of long-term hemodialysis has increased the life span of individuals with chronic renal failure and produced an increased population of patients with secondary hyperparathyroidism and resultant bony changes. The ophthalmologist should consider brown tumor in the differential diagnosis of a patient with chronic renal failure and ocular symptomatology.