Multiple endocrine neoplasia type 1 with brown tumors as first manifestation in a patient with pituitary adenoma: A case report

Introduction:
Multiple endocrine neoplasia type 1 (MEN 1) is an infrequent autosomal dominant hereditary syndrome. Common manifestations are related to hypercalcemia, which is caused by primary hyperparathyroidism (PHPT). Brown tumors are infrequent as initial presentation of PHPT associated with MEN 1. It occurs in less than 2% of MEN 1 population.

Results:
A 36-year-old woman started the disease 25 years ago in an insidious and progressive manner. She presented a soft tumor in the left malar region that progressively increased in volume. We treated recurrent multiple brown tumors in a patient with PHPT and pituitary adenoma.

Conclusions:
The follow-up was demanding and multidisciplinary. The long-term prognosis is uncertain; therefore, close monitoring of the patient should be carried out through clinical, laboratory and imaging evaluation.

REFERENCES (9)

Lu Y-Y, Zhu F, Jing D-D, et al. Multiple endocrine neoplasia type 1 with upper gastrointestinal hemorrhage and perforation: A case report and review. World J Gastroenterol. 2013;19(8):1322-6. https://doi.org/10.3748/wjg.v1... PMid:23482249 PMCid:PMC3587492.

CrossRef

Pubmed

Pubmed Central

Google Scholar

Ito T, Igarashi H, Uehara H, Berna MJ, Jensen RT. Causes of death and prognostic factors in multiple endocrine neoplasia type 1: A prospective study: Comparison of 106 MEN1/Zollinger-Ellison syndrome patients with 1613 literature MEN1 patients with or without pancreatic endocrine tumors. Medicine (Baltimore). 2013;92(3):135-81. https://doi.org/10.1097/MD.0b0... PMid:23645327 PMCid:PMC3727638.

Al-Gahtany M, Cusimano M, Singer W, Bilbao J, Kovacs K, Marotta T. Brown tumors of the skull base. Case report and review of the literature. J Neurosurg. 2003;98(2):417-20. https://doi.org/10.3171/jns.20... PMid:12593633.

CrossRef

Pubmed

Google Scholar

Qaisi M, Loeb M, Montague L, Caloss R. Mandibular brown tumor of secondary hyperparathyroidism requiring extensive resection: A forgotten entity in the developed world? Case Rep Med. 2015;2015:567543. https://doi.org/10.1155/2015/5... PMid:26413096 PMCid:PMC4556817.

Cicconetti A, Matteini C, Piro FR. Differential diagnosis in a case of brown tumor caused by primary hyperparathyroidism. Minerva Stomatol. 1999;48(11):553-8. PMid:10768015.

Pubmed

Google Scholar

Di Meo G, Sgaramella LI, Ferraro V, Prete FP, Gurrado A, Testini M. Parathyroid carcinoma in multiple endocrine neoplasm type 1 syndrome: Case report and systematic literature review. Clin Exp Med. 2018;18(4):585-93. https://doi.org/10.1007/s10238... PMid:29922966.

CrossRef

Pubmed

Google Scholar

Khaladkar SM, Bhatwal AS, Mahajan A, Goyal DS. Brown tumour of maxilla presenting as first manifestation of primary hyperparathyroidism due to parathyroid adenoma–Case report with radiological review. Int J Health Sci Res. 2015;5(10):410-6.

Google Scholar

Artul S, Bowirrat A, Yassin M, Armaly Z. Maxillary and frontal bone simultaneously involved in brown tumor due to secondary hyperparathyroidism in a hemodialysis patient. Case Rep Oncol Med. 2013;2013:909150. https://doi.org/10.1155/2013/9... PMid:24024056 PMCid:PMC3760209.

Aghaghazvini L, Sharifian H, Rasuli B. Primary hyperparathyroidism misdiagnosed as giant cell bone tumor of maxillary sinus: A case report. Iran J Radiol. 2016;13(1):e13260. https://doi.org/10.5812/iranjr... PMid:27127572 PMCid:PMC4841893.