Primary hyperparathyroidism during pregnancy with multiple brown tumors:a case report and literature review
Objective To report one case of gestational brown tumor treated in our hospital and analyze its clinical data,along with 5 cases of gestational brown tumor reported in literature review.Methods The clinical data of a patient with gestational brown tumor were reviewed,and the Chinese and English databases were searched.The literature data of 5 cases retrieved were reviewed for comprehensive analysis.Results A 29-year-old pregnant woman came to our hospital for a follow-up examination 2 months after the right lower limb bone tumor resection and bone transplantation.Magnetic resonance imaging of the knee joint showed abnormal high signal in the medial condyle of the right femur,upper tibia and fibula,and medial patella.Three days later,the patient terminated the pregnancy and developed a pathological fracture of the left forearm two weeks after termination.Laboratory and imaging examinations diagnosed bilateral parathyroid adenoma.Bilateral parathyroid adenoma resection was performed,and new bone callus was clearly visible at the pathological fracture site 2 months after the surgery.As the bone remineralized,multiple fibrocystic osteoarthritis gradually subsided.Five cases of gestational brown tumor were retrieved.All 5 cases underwent parathyroidectomy.Symptoms disappeared in 4 cases and bone remineralization occurred,while the results of 1 case were unknown.Conclusions Brown tumors during pregnancy are easily be misdiagnosed as giant cell tumors or malignant bone tumors.Hyperparathyroidism accompanied by brown tumors can cause multiple osteolytic lesions in the limbs,regular serum calcium and parathyroid hormone measurements should be conducted when studying these lesions.Timely and appropriate treatment can reduce the risk during pregnancy for both mother and fetus.
万方数据
维普
