Brown tumor of the cervical spine with primary hyperparathyroidism: A case report and literature review

Rationale:Brown tumor (BT), an uncommon focal lytic bone tumor, is a non-neoplastic and reactive process caused by increased osteoclastic activity and fibroblastic proliferation in primary or secondary hyperparathyroidism. Vertebral tumor causing neural compression is relatively rare, especially in the cervical spine. Patient concerns:A 29-year-old man developed neck pain and arm radicular pain 4 months ago, with the level of serum calcium significantly higher than normal. Computed tomography scan of the cervical spine revealed an expansile lytic lesion occupying the C6 body, left pedicle, and left lamina of C5-6. Diagnoses:Osteoclastoma according to imaging and histopathological results. Interventions:A laminectomy of C5-6 was performed. Outcomes:One month later, he was re-hospitalized due to nausea and vomiting and the serum calcium, was still, kept at a high level. Additionally, the parathormone (PTH) was greatly higher than normal. BT with primary hyperparathyroidism due to the parathyroid tumor was considered. After the surgery of the right parathyroid gland was performed, serum calcium and PTH both decreased, and computed tomography showed good recovery. Lessons:BTs might be misdiagnosed as other giant cell tumors, thus when giant cell tumors are considered, serum calcium and PTH examination may be needed to exclude BTs.

Automated summary

This article reports a case of cervical spine neural compression caused by parathyroid tumor. The patient presented with neck pain and arm radicular pain, accompanied by significantly elevated serum calcium levels. CT scan of the cervical spine showed an expansile lytic lesion in the C6 body, left pedicle, and left lamina of C5-6. After surgery, the patient developed nausea and vomiting, and serum calcium levels remained high. Based on serological examinations and histopathological results, BT with primary hyperparathyroidism due to the parathyroid tumor was considered. After surgery, serum calcium and PTH levels decreased, and CT showed good recovery.