A patient undergoing maintenance hemodialysis for more than four years had diffuse bone pain and was found to have multiple, lytic bone lesions on x-ray film. Absence of subperiosteal bone resorption led to a presumptive diagnosis of metastatic neoplasm. The bone biopsy specimen showed a brown tumor. Parathyroid exploration showed four diffusely hyperplastic glands, consistent with secondary hyperparathyroidism. To our knowledge, brown tumors without subperiosteal bone resorption have not been reported in patients with secondary hyperparathyroidism.
(JAMA 230:870-872, 1974)
Idelson BA, Rudikoff J, Smith GW. Renal OsteodystrophyUnusual Roentgenologic Manifestation. JAMA. 1974;230(6):870–872. doi:10.1001/jama.1974.03240060040030
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