{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T21:25:42Z","timestamp":1778361942530,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,17]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Brown tumours of bone are highly vascular osteolytic lesions that depict a reparative cellular process instead of a neoplastic process in hyperparathyroidism (HPT) patients. These tumours have the potential to be aggressive and destructive. We report a case of a 30-year-old woman who presented with left thigh and lower back pain. The radiological evaluation showed multiple bony lesions in the pelvis and the spine, which mimicked multiple metastatic tumours. However, on biochemistry evaluation, serum calcium, alkaline phosphatase, and parathyroid hormone were all high, while serum phosphate was low, indicating primary HPT (PHPT), which was confirmed by parathyroid scintigraphy showing left parathyroid adenoma. Hence, the bony lesions were diagnosed as brown tumours secondary to PHPT. The patient underwent parathyroidectomy and developed severe hungry bone syndrome requiring parenteral calcium infusion along with oral calcium and active vitamin D supplementation. The clinical symptoms of bone pain improved after surgery.<\/jats:p>","DOI":"10.1136\/bcr-2021-243478","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T12:50:56Z","timestamp":1626180656000},"page":"e243478","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Brown tumour mimicking skeletal metastasis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1972-7683","authenticated-orcid":false,"given":"Pankti","family":"Parikh","sequence":"first","affiliation":[{"name":"Department of Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahana","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0488-5040","authenticated-orcid":false,"given":"Gabriel","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9545-4838","authenticated-orcid":false,"given":"Shyamasunder N","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"2025082804010270000_14.7.e243478.1","first-page":"191","article-title":"Brown tumour: presenting symptom of primary hyperparathyroidism","volume":"1","author":"Grulois","year":"2005","journal-title":"B-ENT"},{"key":"2025082804010270000_14.7.e243478.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-007-0312-0"},{"key":"2025082804010270000_14.7.e243478.3","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/S0140-6736(80)91783-3","article-title":"Primary hyperparathyroidism: changes in the pattern of clinical presentation","volume":"1","author":"Mundy","year":"1980","journal-title":"Lancet"},{"key":"2025082804010270000_14.7.e243478.4","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.104"},{"key":"2025082804010270000_14.7.e243478.5","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X12441869"},{"key":"2025082804010270000_14.7.e243478.6","doi-asserted-by":"publisher","DOI":"10.1590\/0004-2730000003381"},{"key":"2025082804010270000_14.7.e243478.7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.81.11.4007"},{"key":"2025082804010270000_14.7.e243478.8","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1210\/jc.2017-01932","article-title":"Skeletal microstructure and estimated bone strength improve following parathyroidectomy in primary hyperparathyroidism","volume":"103","author":"Cusano","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082804010270000_14.7.e243478.9","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-0528"},{"key":"2025082804010270000_14.7.e243478.10","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.nutres.2003.10.016","article-title":"Hungry bone syndrome: a case report and review of the literature","volume":"24","author":"Ghanaat","year":"2004","journal-title":"Nutr Res"},{"key":"2025082804010270000_14.7.e243478.11","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2002.128484"},{"key":"2025082804010270000_14.7.e243478.12","first-page":"379","article-title":"Lessons learned from the management of hungry bone syndrome following the removal of an atypical parathyroid adenoma","volume":"19","author":"Florakis","year":"2019","journal-title":"J Musculoskelet Neuronal Interact"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243478","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:01:09Z","timestamp":1756378869000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-243478"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243478","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}