{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:56:14Z","timestamp":1789422974233,"version":"build-2803163510"},"reference-count":112,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T00:00:00Z","timestamp":1692057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Osteitis fibrosa cystica (OFC) and Brown Tumours are two related but distinct types of bone lesions that result from the overactivity of osteoclasts and are most often associated with chronic kidney disease (CKD). Despite their potential consequences, these conditions are poorly understood because of their rare prevalence and variability in their clinical manifestation. Canonically, OFC and Brown Tumours are caused by secondary hyperparathyroidism in CKD. Recent literature showed that multiple factors, such as hyperactivation of the renin\u2013angiotensin\u2013aldosterone system and chronic inflammation, may also contribute to the occurrence of these diseases through osteoclast activation. Moreover, hotspot KRAS mutations were identified in these lesions, placing them in the spectrum of RAS\u2013MAPK-driven neoplasms, which were until recently thought to be reactive lesions. Some risk factors contributed to the occurrence of OFC and Brown Tumours, such as age, gender, comorbidities, and certain medications. The diagnosis of OFC and Brown Tumours includes clinical symptoms involving chronic bone pain and laboratory findings of hyperparathyroidism. In radiological imaging, the X-ray and Computed tomography (CT) scan could show lytic or multi-lobular cystic alterations. Histologically, both lesions are characterized by clustered osteoclasts in a fibrotic hemorrhagic background. Based on the latest understanding of the mechanism of OFC, this review elaborates on the manifestation, diagnosis, and available therapies that can be leveraged to prevent the occurrence of OFC and Brown Tumours.<\/jats:p>","DOI":"10.3390\/cancers15164107","type":"journal-article","created":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T11:09:44Z","timestamp":1692097784000},"page":"4107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective"],"prefix":"10.3390","volume":"15","author":[{"given":"Djoko","family":"Santoso","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dr. Soetomo Hospital, Surabaya 60286, Indonesia"},{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mochammad","family":"Thaha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maulana A.","family":"Empitu","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ika Nindya","family":"Kadariswantiningsih","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0522-8659","authenticated-orcid":false,"given":"Satriyo Dwi","family":"Suryantoro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutiara Rizki","family":"Haryati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decsa Medika","family":"Hertanto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Soetomo Hospital, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Pramudya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Soetomo Hospital, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siprianus Ugroseno Yudho","family":"Bintoro","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Soetomo Hospital, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasronudin","family":"Nasronudin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Soetomo Hospital, Surabaya 60286, Indonesia"},{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mochamad Yusuf","family":"Alsagaff","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5603-9487","authenticated-orcid":false,"given":"Hendri","family":"Susilo","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5180-957X","authenticated-orcid":false,"given":"Citrawati Dyah Kencono","family":"Wungu","sequence":"additional","affiliation":[{"name":"Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaas C.","family":"Budhiparama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1513-8104","authenticated-orcid":false,"given":"Pancras C. W.","family":"Hogendoorn","sequence":"additional","affiliation":[{"name":"Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e335","DOI":"10.5001\/omj.2021.120","article-title":"Prevalence of Renal Osteodystrophy and its Related Factors among End-stage Renal Disease Patients Undergoing Hemodialysis: Report from Imam Reza Referral Hospital of Medical University of Kermanshah, Iran","volume":"37","author":"Seyedzadeh","year":"2022","journal-title":"Oman Med. 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