Gouveia Kyle, Bouchard Marc D, Hache Philip, Yan James R, Vukmirovic-Popovic Snezana, Alowami Salem, Johal Herman
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, D02 YN77, Ireland.
J Surg Case Rep. 2025 Mar 26;2025(3):rjaf160. doi: 10.1093/jscr/rjaf160. eCollection 2025 Mar.
We present the case of a 30-year-old pregnant woman who was found to have an aggressive-appearing osteolytic lesion of the left distal femur in the setting of hypercalcemia. Biopsy confirmed a brown tumor secondary to hyperparathyroidism. She underwent a successful parathyroidectomy followed by a Cesarean section. Postpartum, she sustained pathologic fractures of the ipsilateral femur and pelvis due to a fall, requiring operative fixation. She progressed to uncomplicated healing following surgical management. Although brown tumors can appear aggressive on imaging, they typically resolve following treatment of the underlying hyperparathyroidism. Pathologic fractures should be managed according to standard orthopedic principles. Clinicians should include brown tumors in the differential diagnosis when evaluating osteolytic lesions, particularly in the presence of hypercalcemia.
我们报告一例30岁的孕妇，在高钙血症的情况下，其左股骨远端发现有一个表现为侵袭性的溶骨性病变。活检证实为甲状旁腺功能亢进继发的棕色瘤。她成功接受了甲状旁腺切除术，随后进行了剖宫产。产后，她因跌倒导致同侧股骨和骨盆发生病理性骨折，需要手术固定。经过手术治疗，她顺利康复。尽管棕色瘤在影像学上可能表现为侵袭性，但通常在治疗潜在的甲状旁腺功能亢进后会消退。病理性骨折应按照标准的骨科原则进行处理。临床医生在评估溶骨性病变时，尤其是在存在高钙血症的情况下，应将棕色瘤纳入鉴别诊断。
