Brown tumour of hyperparathyroidism

Definition

Highly vascular lytic lesions of the skeleton seen in both primary and secondary hyperparathyroidism

Encountered as differential diagnosis of giant cell tumour.

Most commonly seen with secondary hyperparathyroidism secondary to renal disease. May affect any age.

Can affect any part of the skeleton.

Grossly: brown friable material resulting from accumulation of haemosiderin within areas of haemorrhage.

Microscopically: giant cells aggregate around areas of haemorrhage, in a background of granulation tissue.

Elevated calcium

Decreased phosphate

Elevated parathyroid hormone

Lesions may be single or multiple, and are often cortical in location.

Typically lytic

If the hyperparathyroidism can be corrected the lesions regress.

Can be surgically excised and bone grafted.