Medicine, Health & Food

Medicine, Health & Food

Archive
Join as an Editor/Reviewer

RIGHT TIBIA BROWN TUMOR REVEALING PRIMARY HIPER PARATHYROIDISM : A CASE REPORT

Volume: 136  ,  Issue: 1 , November    Published Date: 10 November 2023
Publisher Name: IJRP
Views: 167  ,  Download: 103 , Pages: 136 - 146    
DOI: 10.47119/IJRP10013611120235652

Authors

# Author Name
1 Lon hitman rizal
2 Andriandi

Abstract

Primary hyperparathyroidism is a systemic endocrine disorder due to parathyroid adenoma accounts for 80 % of cases. This condition is rare and only 2-5% patients have multiple bone brown tumor lesions. Hyperparathyroidism has significant effects on bone remodelling through the action of parathyroid hormone on the musculo skletal system. Brown tumor as result from primary hyperthyroidism is a localized bone cyst and may cause swelling, pathological fracture, and bone pain in the skletal system. Here we would like to present a 30-year-old woman patient with pain on her right tibia that not alleviated by taking a rest. On right tibia radiological examination we found permeative lytic lesion on the metaphysis and diaphysis region with well define margin, septated, with chondroid matrix and expansile lesion to the postero medial cortex of right tibia. Comprehensive medical examination was done to explore the cause of this condition till the underlying disease was treated and we started to administered biphosphanate injection as chemotherapy to treat the skeletal lesion from this patient. The purpose of this case report was to evaluate the effectiveness bisphosphonate as a chemotherapy for brown tumor on the right tibia after the underlying disease for the primary hyperthyroidism treated by hemiparathyroidectomy and hormonal theraphy. After the hyperparathyroidism was confirm due to primary cause of hyperparathyroid adenoma, this patient was performed hemi parathyroidectomy. Parathyroid hormone was controlled by hormonal theraphy and after the value was almost reach normal, we start to administered bisphosphonate injection for 6 months with single dose of biphosphonate injection every month. Radiological examination before and after bisphosphonate administered then was compared to evaluate the radiological changes for this patient. The patient have a good functional outcome after bisphosphonate administered. Bone density with localized pain was observed. There was no adverse effect  after  bisphosphonate injection  with  increasing  of  bone density  on  the lesion,  localized  pain  also  decreases.  Complete and comprehensive treatment for brown tumor followed by biphosphonate administered as chemotherapy combined with hormonal theraphy, resulting better outcome for this patient. Educate and make the patient understand that this condition need time to exclude any related condition which mimicking its. When the underlying disease treated, chemotherapy is able to perform. This condition need hospital with complete facilities and professionals health experts. Long term observation also needed to evaluate and maintain the result after bisphosphonate administered will give patient good functional outcome.

Keywords

  • Giant Cell Tumor
  • primary hyperthyroidism
  • Brown tumor
  • endocrine system