Brown tumor as an indication of a rare parathyroid carcinoma: A diagnostic challenge: Brown tumor reveals parathyroid carcinoma

Noor Riaz; Lexington Lemmon; Hamda Soubagle; Necial Marcelin; Mohammad Masri

doi:10.28982/josam.8288

Authors

Noor Riaz Medical University of the Americas, P.O. Box 701. Charlestown, Nevis, West Indies https://orcid.org/0009-0004-9390-3467
Lexington Lemmon Nova Southeastern University Dr. Kiran C Patel College of Osteopathic Medicine, Fl, United States https://orcid.org/0009-0000-4301-8057
Hamda Soubagle Medical University of the Americas, P.O. Box 701. Charlestown, Nevis, West Indies https://orcid.org/0009-0009-5856-7759
Necial Marcelin Department of General Surgery, Larkin Community Hospital, FL, ZIP CODE 33143, United States https://orcid.org/0009-0003-2680-0014
Mohammad Masri Department of General Surgery, Larkin Community Hospital, FL, ZIP CODE 33143, United States https://orcid.org/0009-0006-0271-5802

DOI:

https://doi.org/10.28982/josam.8288

Keywords:

Brown tumor, Parathyroid carcinoma, Severe hypercalcemia, osteitis fibrosa cystica, Parathyroidectomy, hungry bone syndrome

Abstract

Parathyroid carcinoma is an exceptionally rare cause of primary hyperparathyroidism, comprising less than 1% of cases. Its presentation often overlaps with benign etiologies, thereby posing significant diagnostic challenges. We present a case of a 70-year-old male with a history of prostate cancer who presented with profound hypercalcemia and markedly elevated parathyroid hormone. Imaging revealed lytic rib lesions consistent with osteitis fibrosa cystica (brown tumor). Surgical resection of a parathyroid mass confirmed parathyroid carcinoma. Postoperatively, the patient experienced symptomatic hypocalcemia due to non-adherence with calcium supplementation. This case highlights the need for clinical suspicion of parathyroid carcinoma in cases of severe hypercalcemia and skeletal manifestations and the importance of postoperative management in preventing complications such as hungry bone syndrome.

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