Brown tumor of the spine revealing secondary hyperparathyroidism. Report of a case

Brown tumors are classic skeletal manifestations of hyperparathyroidism usu ally seen in severe forms with subperiosteal bane resorption. They are exce edingly rare at the spine. We report the case of a woman on hemodialysis wh o developed two brown tumors, including one at the spine. as the first mani festations of secondary hyperparathyroidism. There were no neurologic manif estations. The clinical and radiologic abnormalities resolved after parathy roidectomy preceded by a bisphosphonate infusion to prevent possible spinal lysis progression during the immediate postoperative period. In addition t o the location of one of the brown tumors at the spine, unusual features in this case were the explosive onset of hyperparathyroidism and the absence of detectable subperiosteal resorption. We also suggest that bisphosphonate therapy given before parathyroidectomy may be useful in patients with spin al brown tumors. (C) 2000 Editions scientifiques et medicales Elsevier SAS.