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首页> 外文期刊>Bone Reports >Brown tumor diagnosed three years after parathyroidectomy in a patient with nail-patella syndrome: A case report
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Brown tumor diagnosed three years after parathyroidectomy in a patient with nail-patella syndrome: A case report

机译：甲骨syndrome综合征患者甲状旁腺切除术后三年被确诊为棕色肿瘤：一例报告

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We report a 48-year-old Japanese man with a brown tumor of the right distal tibia. At the age of 25?years, hemodialysis was initiated due to nail-patella syndrome. Severe secondary hyperparathyroidism and osteoporosis progressed over time, so parathyroidectomy was performed at age 45. Spontaneous fracture of the right distal tibia occurred suddenly at age 48. Imaging studies revealed a bone tumor-like lesion and surgery was performed. The resected specimen was a brown mass consisting of multinucleated giant cells on a fibrous tissue background, and these findings were consistent with a diagnosis of brown tumor. Immunohistochemistry revealed that multinucleated giant cells near areas of bone matrix were positive for tartrate-resistant acid phosphatase and cathepsin K, but the majority of the giant cells in the lesion were negative for these markers. Even after parathyroidectomy, brown tumor should be considered in the differential diagnosis of bone tumor-like lesions in patients on long-term dialysis. This case suggests that osteoclast activation may not contribute to development of brown tumors, although these lesions are generally considered to arise from subperiosteal bone resorption related to osteoclast overactivity in patients with hyperparathyroidism.
机译：我们报告了一个48岁的日本男子，患有右胫骨远端的棕色肿瘤。在25岁时，由于指甲-骨综合征而开始进行血液透析。随着时间的推移，严重的继发性甲状旁腺功能亢进和骨质疏松症逐渐发展，因此在45岁时进行了甲状旁腺切除术。在48岁时，右胫骨远端自发性骨折突然发生。影像学检查显示骨肿瘤样病变，并进行了手术。切除的标本为棕色团块，由纤维组织背景上的多核巨细胞组成，这些发现与棕色瘤的诊断相符。免疫组织化学显示，骨基质区域附近的多核巨细胞对酒石酸耐药性酸性磷酸酶和组织蛋白酶K呈阳性，但病变中的大多数巨细胞对这些标志物呈阴性。即使在甲状旁腺切除术后，长期透析患者的骨肿瘤样病变的鉴别诊断中也应考虑棕色肿瘤。该病例提示破骨细胞活化可能不会促进棕色肿瘤的发展，尽管通常认为这些病变是由于甲状旁腺功能亢进症患者的破骨细胞过度活跃引起的骨膜下骨吸收引起的。

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