Published in:
01-08-2004 | Case Report
Radicular lower extremity pain as the first symptom of primary hyperparathyroidism
Authors:
Antti O. T. Mustonen, Martti J. Kiuru, Anders Stahls, Tom Bohling, Aarne Kivioja, Seppo K. Koskinen
Published in:
Skeletal Radiology
|
Issue 8/2004
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Abstract
Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism.