{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:15:00Z","timestamp":1791396900752,"version":"4.3.3"},"reference-count":100,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T00:00:00Z","timestamp":1719619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Brown tumors, an exceptional bone complication of severe primary (PHP) or renal (secondary) hyperparathyroidism (RHP), are caused by long-standing, elevated parathormone (PTH)-induced osteoclast activation causing multinucleated giant cell conglomerates with hemosiderin deposits in addition to the local production of cytokines and growth factors. We aim to present an adult case series including two females displaying this complication as part of a multidisciplinary complex panel in high PTH-related ailments. The approach was different since they had distinct medical backgrounds and posed a wide area of challenges amid real-life settings, namely, a 38-year-old lady with PHP and long-term uncontrolled hypercalcemia (with a history of pregnancy-associated PHP, the removal of a cystic jaw tumor, as well as a family and personal positive diagnosis of polycystic kidney disease, probably a PHP-jaw tumor syndrome), as well as, a 26-year-old woman with congenital single kidney and chronic renal disease-associated RHP who was poorly controlled under dialysis and developed severe anemia and episodes of metabolic acidosis (including one presentation that required emergency hemodialysis and was complicated with convulsive seizures, followed by resuscitated respiratory arrest). Both subjects displayed a severe picture of PHP\/RHP with PTH levels of &gt;1000 pg\/mL and &gt;2000 pg\/mL and elevated serum bone turnover markers. Additionally, they had multiple brown tumors at the level of the ribs and pelvis (asymptomatically) and the spine, skull, and pelvis (complicated with a spontaneous cervical fracture). As an endocrine approach, the control of the underlying parathyroid disease was provided via surgery in PHP (for the postparathyroidectomy hungry bone syndrome) via medical intervention (with vitamin D analogs) in RHP. Additionally, in this case, since the diagnosis was not clear, a multidisciplinary decision to perform a biopsy was taken (which proved inconclusive), and the resection of the skull tumor to confirm the histological traits. This series highlights the importance of addressing the entire multidisciplinary panel of co-morbidities for a better outcome in patients with PHP\/RHP-related brown tumors. However, in the instance of real-life medicine, poor compliance and reduced adherence to recommendations might impair the overall health status. Thus, sometimes, a direct approach at the level of cystic lesion is taken into consideration; this stands for a narrow frame of decision, and it is a matter of personalized decision. As seen here, brown tumors represent the hidden face of PHP\/RHP, primarily the complex and severe forms, and awareness is essential even in the modern era.<\/jats:p>","DOI":"10.3390\/jcm13133847","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3847","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Brown Tumors: The Hidden Face of Primary and Renal Hyperparathyroidism Amid Real-Life Settings"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8585-3835","authenticated-orcid":false,"given":"Mara","family":"Carsote","sequence":"first","affiliation":[{"name":"Department of Endocrinology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Clinical Endocrinology V, C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4402-7194","authenticated-orcid":false,"given":"Mihai-Lucian","family":"Ciobica","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Internal Medicine I and Rheumatology, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana-Claudia","family":"Sima","sequence":"additional","affiliation":[{"name":"Department of Clinical Endocrinology V, C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania"},{"name":"PhD Doctoral School, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Valea","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Department of Endocrinology, County Emergency Clinical Hospital, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-4188","authenticated-orcid":false,"given":"Cosmina Ioana","family":"Bondor","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea","family":"Geleriu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sibiu Clinical County Hospital, 550245 Sibiu, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Ticolea","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-5666","authenticated-orcid":false,"given":"Claudiu","family":"Nistor","sequence":"additional","affiliation":[{"name":"Department 4\u2014Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Thoracic Surgery Department, \u201cDr. Carol Davila\u201d Central Emergency University Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7708-9320","authenticated-orcid":false,"given":"Crina Claudia","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"\u201cMihai Manasia\u201d Nephrology and Dialysis Clinic, County Emergency Clinical Hospital Cluj, 400347 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"590","DOI":"10.21873\/cdp.10259","article-title":"Multiple Bone Cysts Caused by Hyperparathyroidism: A Case Report and Review of the Literature","volume":"3","author":"Miwa","year":"2023","journal-title":"Cancer Diagn. Progn."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E1073","DOI":"10.1097\/BRS.0000000000000455","article-title":"Brown tumor of the spine in patients with primary hyperparathyroidism","volume":"39","author":"Khalatbari","year":"2014","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13256-024-04408-3","article-title":"Diagnostic dilemma in maxillofacial pathologies: A case series","volume":"18","author":"Sarda","year":"2024","journal-title":"J. Med. Case Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4103\/jomfp.JOMFP_166_19","article-title":"A complex case of brown tumors as initial manifestation of primary hyperparathyroidism in a young female","volume":"23","author":"Manjunatha","year":"2019","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Diao, Z., Zhang, J., Zhao, J., Sun, W., and Pu, Z. (2023). Brown tumor due to primary hyperparathyroidism in a familial case: A case report. BMC Endocr. Disord., 23.","DOI":"10.1186\/s12902-023-01475-3"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhong, Y., Huang, Y., Luo, J., and Ye, Y. (2022). Misdiagnosis of brown tumour caused by primary hyperparathyroidism: A case report with literature review. BMC Endocr. Disord., 22.","DOI":"10.1186\/s12902-022-00971-2"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s12020-017-1414-2","article-title":"Osteitis fibrosa cystica-a forgotten radiological feature of primary hyperparathyroidism","volume":"58","author":"Misiorowski","year":"2017","journal-title":"Endocrine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e28333","DOI":"10.1016\/j.heliyon.2024.e28333","article-title":"Unusual body weight loss due to primary hyperparathyroidism: A case study with literature review","volume":"10","author":"Lin","year":"2024","journal-title":"Heliyon"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Vanitcharoenkul, E., Singsampun, N., Unnanuntana, A., and Sirinvaravong, S. (2021). Osteitis Fibrosa Cystica and pathological fractures-the classic but neglected skeletal manifestation of primary hyperparathyroidism: A case report. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04326-1"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.beem.2018.09.001","article-title":"Classical complications of primary hyperparathyroidism","volume":"32","author":"Minisola","year":"2018","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"983","DOI":"10.4158\/EP-2020-0095","article-title":"Radiologic Manifestation of Bone Involvement in Primary Hyperparathyroidism: Prevalence and Clinical Significance in a Southern European Series","volume":"26","author":"Castellano","year":"2020","journal-title":"Endocr. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s10354-013-0235-z","article-title":"Clinical aspects of primary hyperparathyroidism: Clinical manifestations, diagnosis, and therapy","volume":"163","author":"Gasser","year":"2013","journal-title":"Wien Med. Wochenschr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/MAJ.0000000000000441","article-title":"Skeletal lesions in primary hyperparathyroidism","volume":"349","author":"Yang","year":"2015","journal-title":"Am. J. Med. Sci."},{"key":"ref_14","first-page":"e47461","article-title":"Ectopic Intrathyroidal Parathyroid Adenoma Presenting with Osteoporotic Fractures in a Young Man: A Case Report","volume":"15","author":"Cosme","year":"2023","journal-title":"Cureus"},{"key":"ref_15","first-page":"e33820","article-title":"Secondary Hyperparathyroidism Presenting as a Brown Tumor: A Case Report and Review of the Literature","volume":"15","author":"Flores","year":"2023","journal-title":"Cureus"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e32768","DOI":"10.1097\/MD.0000000000032768","article-title":"Brown tumor of the cervical spine with primary hyperparathyroidism: A case report and literature review","volume":"102","author":"Liu","year":"2023","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"527","DOI":"10.4103\/jomfp.jomfp_157_21","article-title":"Maxillary brown tumor due to secondary hyperparathyroidism in a Hemodialysis patient: A case report and literature review","volume":"25","author":"Aravindhan","year":"2021","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.ecl.2021.07.006","article-title":"Sporadic Primary Hyperparathyroidism","volume":"50","author":"Kim","year":"2021","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"108823","DOI":"10.1016\/j.ijscr.2023.108823","article-title":"Brown tumor of the jaw as a rare manifestation of hyperparathyroidism: Two case reports and literature review","volume":"111","author":"Hakkou","year":"2023","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11795514231210143","DOI":"10.1177\/11795514231210143","article-title":"Brown Tumors of the Jaws: A Retrospective Study","volume":"16","author":"Fedhila","year":"2023","journal-title":"Clin. Med. Insights Endocrinol. Diabetes"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.12998\/wjcc.v12.i7.1200","article-title":"Expect the unexpected: Brown tumor of the mandible as the first manifestation of primary hyperparathyroidism","volume":"12","author":"Zajc","year":"2024","journal-title":"World J. Clin. Cases"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s13256-018-1723-y","article-title":"Osteolytic lesions (brown tumors) of primary hyperparathyroidism misdiagnosed as multifocal giant cell tumor of the distal ulna and radius: A case report","volume":"12","author":"Panagopoulos","year":"2018","journal-title":"J. Med. Case Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.oooo.2021.08.020","article-title":"Manifestations of hyperparathyroidism in the jaws: Concepts, mechanisms, and clinical aspects","volume":"133","author":"Valeriano","year":"2022","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1002\/jbmr.49","article-title":"The role of mast cells in parathyroid bone disease","volume":"25","author":"Turner","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_25","first-page":"83","article-title":"Brown tumor at the jaw in patients with secondary hyperparathyroidism due to chronic renal failure","volume":"56","author":"Pechalova","year":"2013","journal-title":"Acta Medica"},{"key":"ref_26","first-page":"70","article-title":"Brown tumor: Clinical findings of secondary hyperparathyroidism in patients with renal osteodystrophy","volume":"65","author":"Silva","year":"2017","journal-title":"Gen. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Shavlokhova, V., Goeppert, B., Gaida, M.M., Saravi, B., Weichel, F., Vollmer, A., Vollmer, M., Freudlsperger, C., Mertens, C., and Hoffmann, J. (2021). Mandibular Brown Tumor as a Result of Secondary Hyperparathyroidism: A Case Report with 5 Years Follow-Up and Review of the Literature. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18147370"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"217","DOI":"10.11005\/jbm.2020.27.3.217","article-title":"Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome","volume":"27","author":"Bransky","year":"2020","journal-title":"J. Bone Metab."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Staruschenko, A., Alexander, R.T., Caplan, M.J., and Ilatovskaya, D.V. (2024). Calcium signalling and transport in the kidney. Nat. Rev. Nephrol.","DOI":"10.1038\/s41581-024-00835-z"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zechner, C., and Rhee, E.P. (2024). Phosphate sensing in health and disease. Curr. Opin. Nephrol. Hypertens.","DOI":"10.1097\/MNH.0000000000000984"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Simic, P. (2024). Bone and bone derived factors in kidney disease. Front. Physiol., 15.","DOI":"10.3389\/fphys.2024.1356069"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Villabrille, S., Mart\u00edn-Carro, B., Mart\u00edn-V\u00edrgala, J., Rodr\u00edguez-Santamaria, M.D.M., Baena-Huerta, F., Mu\u00f1oz-Casta\u00f1eda, J.R., Fern\u00e1ndez-Mart\u00edn, J.L., Alonso-Montes, C., Naves-D\u00edaz, M., and Carrillo-L\u00f3pez, N. (2024). Novel Biomarkers of Bone Metabolism. Nutrients, 16.","DOI":"10.3390\/nu16050605"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1053\/j.ajkd.2020.12.024","article-title":"Osteoporosis and Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD): Back to Basics","volume":"78","author":"Pazianas","year":"2021","journal-title":"Am. J. Kidney Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Santoso, D., Thaha, M., Empitu, M.A., Kadariswantiningsih, I.N., Suryantoro, S.D., Haryati, M.R., Hertanto, D.M., Pramudya, D., Bintoro, S.U.Y., and Nasronudin, N. (2023). Brown Tumour in Chronic Kidney Disease: Revisiting an Old Disease with a New Perspective. Cancers, 15.","DOI":"10.20944\/preprints202307.1099.v1"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"835","DOI":"10.5551\/jat.RV22006","article-title":"Role of Chronic Kidney Disease (CKD)-Mineral and Bone Disorder (MBD) in the Pathogenesis of Cardiovascular Disease in CKD","volume":"30","author":"Yamada","year":"2023","journal-title":"J. Atheroscler. Thromb"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Fusaro, M., Pereira, L., and Bover, J. (2023). Current and Emerging Markers and Tools Used in the Diagnosis and Management of Chronic Kidney Disease-Mineral and Bone Disorder in Non-Dialysis Adult Patients. J. Clin. Med., 12.","DOI":"10.3390\/jcm12196306"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Tsuchiya, K., and Akihisa, T. (2021). The Importance of Phosphate Control in Chronic Kidney Disease. Nutrients, 13.","DOI":"10.3390\/nu13051670"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"959","DOI":"10.3892\/etm.2021.10391","article-title":"Attitude of the surgical approach in hyperparathyroidism: A retrospective study","volume":"22","author":"Nistor","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1507\/endocrj.K05-175","article-title":"Multiple brown tumors in primary hyperparathyroidism caused by an adenoma mimicking metastatic bone disease with false positive results on computed tomography and Tc-99m sestamibi imaging: MR findings","volume":"54","author":"Miyakoshi","year":"2007","journal-title":"Endocr. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/hdi.12298","article-title":"Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report","volume":"19","author":"Baracaldo","year":"2015","journal-title":"Hemodial. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1093\/ageing\/afu093","article-title":"National Osteoporosis Society vitamin D guideline summary","volume":"43","author":"Aspray","year":"2014","journal-title":"Age Ageing"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Sevva, C., Divanis, D., Tsinari, A., Grammenos, P., Laskou, S., Mantalobas, S., Paschou, E., Magra, V., Kopsidas, P., and Kesisoglou, I. (2024). Pharmaceutical Management of Secondary Hyperparathyroidism and the Role of Surgery: A 5-Year Retrospective Study. Medicina, 60.","DOI":"10.3390\/medicina60050812"},{"key":"ref_43","first-page":"e2024E004","article-title":"Severe secondary hyperparathyroidism: An increasing problem in CKD but the best management option is still unknown","volume":"46","author":"Tiong","year":"2024","journal-title":"J. Bras. Nefrol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s40001-024-01801-y","article-title":"A nomogram prediction model for hungry bone syndrome in dialysis patients with secondary hyperparathyroidism after total parathyroidectomy","volume":"29","author":"Gao","year":"2024","journal-title":"Eur. J. Med. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/MNH.0000000000000327","article-title":"Hungry bone syndrome","volume":"26","author":"Jain","year":"2017","journal-title":"Curr. Opin. Nephrol. Hypertens"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1530\/EJE-12-0528","article-title":"Hungry bone syndrome: Still a challenge in the post-operative management of primary hyperparathyroidism: A systematic review of the literature","volume":"168","author":"Witteveen","year":"2013","journal-title":"Eur. J. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"317","DOI":"10.21614\/chirurgia.2719","article-title":"Cervico-Thoracic Air Collections in COVID-19 Pneumonia Patients-Our Experience and Brief Review","volume":"117","author":"Nistor","year":"2022","journal-title":"Chirurgia"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Aojula, N., Ready, A., Gittoes, N., and Hassan-Smith, Z. (2021). Management of Parathyroid Disease during the COVID-19 Pandemic. J. Clin. Med., 10.","DOI":"10.3390\/jcm10050920"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.clinthera.2021.02.003","article-title":"Management of Primary Hyperparathyroidism with Severe Hypercalcemia During the COVID-19 Pandemic","volume":"43","author":"Alfadhli","year":"2021","journal-title":"Clin. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4323\/rjlm.2022.112","article-title":"Pneumothorax on COVID-19 patients-retrospective clinical observations","volume":"30","author":"Nistor","year":"2022","journal-title":"Rom. J. Leg Med."},{"key":"ref_51","first-page":"3969542","article-title":"Giant Parathyroid Adenoma-Associated Fracture, Not All Lytic Bone Lesions are Cancer: A Case-Based Review","volume":"2022","author":"Ribero","year":"2022","journal-title":"Case Rep. Med."},{"key":"ref_52","first-page":"20-0029","article-title":"Brown tumor of the iliac crest initially misdiagnosed as a giant cell tumor of the bone","volume":"2020","author":"Hamidi","year":"2020","journal-title":"Endocrinol. Diabetes Metab. Case Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.4103\/jomfp.JOMFP_319_19","article-title":"Multifocal osteolytic lesions of jaw as a road map to diagnosis of brown tumor of hyperparathyroidism: A rare case report with review of literature","volume":"24","author":"Gosavi","year":"2020","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s11926-015-0523-2","article-title":"Hyperparathyroidism and Bone Health","volume":"17","author":"Bandeira","year":"2015","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s11154-020-09614-0","article-title":"Skeletal abnormalities in Hypoparathyroidism and in Primary Hyperparathyroidism","volume":"22","author":"Silva","year":"2021","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1590\/0004-2730000003381","article-title":"Bone disease in primary hyperparathyroidism","volume":"58","author":"Bandeira","year":"2014","journal-title":"Arq. Bras. Endocrinol. Metabol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s11914-020-00574-7","article-title":"Effects of PTH and PTH Hypersecretion on Bone: A Clinical Perspective","volume":"18","author":"Rejnmark","year":"2020","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"666","DOI":"10.20945\/2359-3997000000556","article-title":"Normocalcemic primary hyperparathyroidism","volume":"66","author":"Cusano","year":"2022","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"bvad013","DOI":"10.1210\/jendso\/bvad013","article-title":"The Eucalcemic Patient with Elevated Parathyroid Hormone Levels","volume":"7","author":"Shaker","year":"2023","journal-title":"J. Endocr. Soc."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.otc.2023.07.012","article-title":"Surgery for Normocalcemic Hyperparathyroidism","volume":"57","author":"Kulkarni","year":"2024","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_61","first-page":"1266","article-title":"Giant parathyroid adenoma diagnosed by brown tumour, a clinical manifestation of primary hyperparathyroidism: A case report","volume":"71","author":"Yigit","year":"2021","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_62","first-page":"e16388","article-title":"Secondary Hyperparathyroidism in Chronic Kidney Disease: Pathophysiology and Management","volume":"13","author":"Habas","year":"2021","journal-title":"Cureus"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3083","DOI":"10.21873\/anticanres.15092","article-title":"Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism-A Case Report and Systematic Review of the Current Literature","volume":"41","author":"Keiler","year":"2021","journal-title":"Anticancer Res."},{"key":"ref_64","first-page":"20-0046","article-title":"When primary hyperparathyroidism comes as good news. Endocrinol","volume":"2020","author":"Gallo","year":"2020","journal-title":"Diabetes Metab. Case Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/1759720X12441869","article-title":"Bone disease in primary hyperparathyrodism","volume":"4","author":"Marcocci","year":"2012","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Haarhaus, M., Cianciolo, G., Barbuto, S., La Manna, G., Gasperoni, L., Tripepi, G., Plebani, M., Fusaro, M., and Magnusson, P. (2022). Alkaline Phosphatase: An Old Friend as Treatment Target for Cardiovascular and Mineral Bone Disorders in Chronic Kidney Disease. Nutrients, 14.","DOI":"10.3390\/nu14102124"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1053\/j.ajkd.2013.02.366","article-title":"Bone alkaline phosphatase in CKD-mineral bone disorder","volume":"62","author":"Sardiwal","year":"2013","journal-title":"Am. J. Kidney Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.cca.2019.11.012","article-title":"Bone alkaline phosphatase: An important biomarker in chronic kidney disease-mineral and bone disorder","volume":"501","author":"Nizet","year":"2020","journal-title":"Clin. Chim. Acta"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/0886022X.2022.2048856","article-title":"Risk factors for hypocalcemia in dialysis patients with refractory secondary hyperparathyroidism after parathyroidectomy: A meta-analysis","volume":"44","author":"Gao","year":"2022","journal-title":"Ren. Fail"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"10712","DOI":"10.21037\/apm-21-2509","article-title":"Predictive markers for severe hypocalcemia in dialysis patients with secondary hyperparathyroidism after near-total parathyroidectomy","volume":"10","author":"Zou","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_71","first-page":"2217","article-title":"Predictive analysis of severe hypocalcemia following total parathyroidectomy for renal secondary hyperparathyroidism","volume":"28","author":"Bi","year":"2024","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_72","first-page":"341","article-title":"Osteoporosis and the fracture risk in systemic lupus erythematosus","volume":"CXXIII","author":"Ionescu","year":"2020","journal-title":"Rom. J. Mil. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s43465-023-01019-w","article-title":"Osteoporosis: Investigations and Monitoring","volume":"57","author":"Panchagnula","year":"2023","journal-title":"Indian J. Orthop."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Tamimi, R., Bdair, A., Shratih, A., Abdalla, M., Sarsour, A., Hamdan, Z., and Nazzal, Z. (2024). Bone mineral density and related clinical and laboratory factors in peritoneal dialysis patients: Implications for bone health management. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0301814"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Rajab, H.A. (2022). The Effect of Vitamin D Level on Parathyroid Hormone and Alkaline Phosphatase. Diagnostics, 12.","DOI":"10.3390\/diagnostics12112828"},{"key":"ref_76","first-page":"26","article-title":"Atherosclerosis in rheumatoid arthritis\u2013The importance of imaging testing","volume":"CXXIII","author":"Ionescu","year":"2020","journal-title":"Rom. J. Mil. Med."},{"key":"ref_77","first-page":"20584601221128415","article-title":"Brown tumor mimicking metastases-the late manifestation of hyperparathyroidism","volume":"11","author":"Tram","year":"2022","journal-title":"Acta Radiol. Open"},{"key":"ref_78","first-page":"39","article-title":"Ankylosing spondylitis and cardiovascular risk\u2013case report","volume":"CXIX","author":"Anghel","year":"2016","journal-title":"Rom. J. Mil. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s12149-023-01832-1","article-title":"Brown tumors in nuclear medicine: A systematic review","volume":"37","author":"Prevot","year":"2023","journal-title":"Ann. Nucl. Med."},{"key":"ref_80","first-page":"43","article-title":"Beh\u00e7et disease\u2013Case presentation","volume":"CXIX","author":"Stanciu","year":"2016","journal-title":"Rom. J. Mil. Med."},{"key":"ref_81","first-page":"897","article-title":"Betadine in chemical pleurodesis","volume":"62","author":"Nistor","year":"2014","journal-title":"Farmacia"},{"key":"ref_82","first-page":"831","article-title":"A rare case of digestive hemorrhage in an elderly patient: Diagnosis and treatment difficulties","volume":"53","author":"Jinga","year":"2012","journal-title":"Rom J. Morphol. Embryol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Prodana, M., Nistor, C.E., Stoian, A.B., Ionita, D., and Burnei, C. (2020). Dual nanofibrous bioactive coarings on TiZr implants. Coatings, 10.","DOI":"10.3390\/coatings10060526"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Nistor, C.E., Ciuche, A., Cucu, A.P., Serban, B., Cursaru, A., Cretu, B., and Cirstoiu, C. (2022). Clavicular Malignancies: A Borderline Surgical Management. Medicina, 58.","DOI":"10.3390\/medicina58070910"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Nasser, M.L., Medawar, S., Younan, T., Abboud, H., and Trak-Smayra, V. (2021). Osteitis fibrosa cystica mimicking bone tumor, a case report. BMC Musculoskelet. Disord., 22.","DOI":"10.1186\/s12891-021-04374-7"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s13256-017-1296-1","article-title":"A patient with a history of breast cancer and multiple bone lesions: A case report","volume":"11","author":"Schnyder","year":"2017","journal-title":"J. Med. Case Rep."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"449","DOI":"10.25122\/jml-2019-0131","article-title":"Glucocorticoids and Trabecular Bone Score","volume":"13","author":"Sandru","year":"2020","journal-title":"J Med Life."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e05331","DOI":"10.1002\/ccr3.5331","article-title":"Missed C5 vertebral brown tumor causing spinal cord compression and myelopathy: A case report and literature review","volume":"10","author":"Mirzashahi","year":"2022","journal-title":"Clin. Case Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10006-016-0575-0","article-title":"Brown tumor of secondary hyperparathyroidism: Surgical approach and clinical outcome","volume":"20","author":"Queiroz","year":"2016","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Uysal, C., Yilmaz, T., Ozkan, H., Canoz, O., and Tokgoz, B. (2024). The refractory secondary hyperparathyroidism presenting with retro-orbital brown tumor: A case report. BMC Nephrol., 25.","DOI":"10.1186\/s12882-024-03455-8"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000348636","article-title":"Evaluation of anemia and serum iPTH, calcium, and phosphorus in patients with primary glomerulonephritis","volume":"181","author":"Li","year":"2013","journal-title":"Contrib. Nephrol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2210227","DOI":"10.1080\/0886022X.2023.2210227","article-title":"Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease","volume":"45","author":"Li","year":"2023","journal-title":"Ren. Fail."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2478\/bjmg-2023-0003","article-title":"The Predisposition for Type 2 Diabetes Mellitus and Metabolic Syndrome","volume":"26","author":"Berca","year":"2023","journal-title":"Balkan J. Med. Genet."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"43","DOI":"10.4103\/ijmr.IJMR_1200_19","article-title":"Haematological manifestations in primary hyperparathyroidism","volume":"155","author":"Polat","year":"2022","journal-title":"Indian J. Med. Res."},{"key":"ref_95","first-page":"531","article-title":"Diagnosis and management of primary hyperparathyroidism during pregnancy: A systematic review and a longitudinal case study","volume":"51","author":"Amara","year":"2023","journal-title":"Gynecol. Obstet. Fertil. Senol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.rx.2023.03.004","article-title":"Multiple and hereditary renal tumors: A review for radiologists","volume":"66","author":"Fraino","year":"2024","journal-title":"Radiologia"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Cetani, F., Dinoi, E., Pierotti, L., and Pardi, E. (2024). Familial states of primary hyperparathyroidism: An update. J. Endocrinol. Investig.","DOI":"10.1007\/s40618-024-02366-7"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"luae020","DOI":"10.1210\/jcemcr\/luae020","article-title":"Hyperparathyroidism Jaw Tumor Syndrome, an Unforeseen Diagnosis","volume":"2","author":"Zama","year":"2024","journal-title":"JCEM Case Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e936135","DOI":"10.12659\/AJCR.936135","article-title":"Association between Parafibromin Expression and Presence of Brown Tumors and Jaw Tumors in Patients with Primary Hyperparathyroidism: Series of Cases with Review of the Literature","volume":"23","author":"Popow","year":"2022","journal-title":"Am. J. Case Rep."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s42000-023-00508-9","article-title":"Genetics of hereditary forms of primary hyperparathyroidism","volume":"23","author":"English","year":"2024","journal-title":"Hormones"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3847\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:08:04Z","timestamp":1760108884000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/13\/3847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,29]]},"references-count":100,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jcm13133847"],"URL":"https:\/\/doi.org\/10.3390\/jcm13133847","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,29]]}}}