# Multiple spinal brown tumors presenting as compressive thoracic myelopathy in a patient on maintenance hemodialysis

## TL;DR

A rare case of multiple spinal brown tumors causing spinal compression in a hemodialysis patient is reported, highlighting the importance of early diagnosis to prevent neurological damage.

## Contribution

This case report adds to the limited literature on spinal brown tumors in patients with chronic kidney disease.

## Key findings

- Brown tumors were diagnosed in a hemodialysis patient with elevated parathyroid hormone and confirmed via imaging and histopathology.
- Spinal brown tumors are rare and can mimic other spinal lesions, requiring careful differential diagnosis.
- Early surgical excision and treatment of secondary hyperparathyroidism improved patient outcomes.

## Abstract

Brown tumor, also known as osteitis fibrosa cystica, is a benign bone lesion due to excessive lytic action by osteoclasts, in the presence of primary, secondary, or tertiary hyperparathyroidism. Due to early screening, they are a rare occurrence. This report presents a case of a 47-year-old man on regular hemodialysis presenting with compressive thoracic myelopathy. Based on elevated parathyroid hormone, imaging, and histopathology, the diagnosis of brown tumor was confirmed. He then underwent tumor excision, following which the underlying secondary hyperparathyroidism was treated with calcitriol and calcium replacement. Though secondary hyperparathyroidism is a common complication of chronic kidney disease, brown tumors are a rare manifestation and uncommonly located in the spine. Differential diagnoses include metastatic lesions, plasmacytomas, giant cell granulomas, or simple bone cysts. Early diagnosis and management of a spinal brown tumor can prevent neurological complications.