Thoracal myelopathy due to a vertebral Brown tumor

End stage renal failure (ESRF) is defined as irreversible and progressive loss of renal function. ESRF has effects on the whole systems of the body. The effects on the musculoskeletal system are variable like osteoporosis, osteosclerosis, osteomalacia, soft tissue calcification and Brown tumors. Brown tumor involving the spine and causing myelopathy is considered very rare. Involvement of the vertebral column is rare and only nine cases of symptomatic Brown tumors that involve the spine have been reported to date. In this report, we present a patient with ESRF who has a Brown tumor placed at thoracal vertebra. A 33-year-old man with a 14 years of hemodialysis presented with sudden upper thoracic pain and bilateral lower extremity weakness. We discussed the CT and MRI findings of this rare entity in the light of the literature findings.