Lytic lesions in bone in a CKD patient, brown tumor is a must on the differential

Abstract

Brown tumor is a focal lesion of giant cells without neoplastic potential encountered in association with hyperparathyroidism. These lesions can occur anywhere in the skeletal system producing various local symptoms. In this case report, we present a 15-year-old boy with stage 5 chronic kidney disease (CKD) on maintenance hemodialysis who presented with hip pain for 1 week. On investigating, the patient had normal parathyroid levels (PTH) but the previous metabolic bone disorder (MBD) parameters revealed a high PTH. Imaging showed expansile radiolucent lesions involving the left hip. Considering the clinical, metabolic and the radiological picture the patient was diagnosed to have brown tumor with secondary hyperparathyroidism and was treated with Cinancalcet, vitamin D and immobilization with a brace.