Neoplasms of the parathyroid glands and brown tumours – A case study

A case of brown tumours concomitant with parathyroid adenoma is described. The patient described shoulder pain following minor trauma. Plain X-rays and MRI showed cystic bone lesions while blood analysis depicted high levels of calcium and parathyroid hormone (PTH). A 99mTc-MDP wholebody bone scintigraphy showed extensive amplified uptake throughout the skeleton, supporting the diagnosis of brown tumours but not dismissing metastatic disease. A 99mTc-Sestamibi Parathyroid Scan showed increased uptake in the right humerus, in the periphery of distal femora as well as tibiae and fibulae, ankles and multiple areas in both hands, supporting the diagnosis of brown tumours rather than metastases. The patient was subjected to a total parathyroidectomy and will receive follow-up to prevent further developments of the disease.