Affiliation: | (1) Toolo Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029 Helsinki, Finland;(2) Department of Pathology, Haartman Institute, University of Helsinki, 00014 Helsinki, Finland;(3) Department of Orthopedics and Traumatology, Helsinki University Central Hospital, 00029 Helsinki, Finland |
Abstract: | Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism. |