Received : 27 August 2001 ;
accepted : 5 December 2001
Radiographic follow-up of a phalangeal brown tumor
Nephrology department, Hôpital Pasteur, 30, avenue de la Voie Romaine, 06202 Nice cedex 1, France
*Correspondence and reprints
We report the 6-year radiographic follow-up of a phalangeal brown tumor in a patient with severe hyperparathyroidism secondary to chronic renal failure treated with hemodialysis. The phalangeal lesion increased in size during the first 3 years, until the patient finally accepted to undergo parathyroidectomy. The initial radiographic change was a small intracortical lytic area. Two years later, an expansile cystic lesion was visible in the phalanx, and computed tomography showed a cortical defect. Ossification of the lesion occurred over the 2.5 years following parathyroidectomy. The epidemiology, radiographic changes and post-treatment evolution of brown tumor in dialysed patients is reviewed. Surgical parathyroidectomy is the standard treatment for brown tumor complicating secondary hyperparathyroidism. The usefulness and limitations of treatment with vitamin D analogs, recently reported in a few case reports, are discussed.
Mots clés : hyperparathyroidism ; parathyroidectomy ; renal failure.
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