대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Chief Complaint

Shoulder pain

Definitive Diagnosis

Ectopic parathyroid adenoma with brown tumors

Past History

Occupation: IT technologist

Reviewy

Parathyroid adenoma
Location
Juxtathyroid (posterior or inferior to thyroid)
Ectopic (5%): mediastinum (m/c)
Clinical manifestations
Primary hyperparathyroidism: Ca, PTH ↑
Osteoporosis, renal stone, brown tumors
Imaging
CT: early strong enhancement with washout, cystic change
Tc 99m MIBI scan

Brown tumor
Pathology
Reparative cellular process:
Bone resorption -> hemorrhage -> reparative granulation tissue
“brown tumor”: hemosiderin deposition
Identical to giant cell tumor
Imaging
Plain radiography: lytic lesion with cortical expansion
CT: similar to attenuation value of fibrous dysplasia
Bone scan/PET-CT: intense uptake

Keywords