Múltiples tumores pardos en una paciente en hemodiálisis con hiperparatiroidismo secundario grave

2002 
espanolDescribimos el caso de una mujer de 29 anos con insuficiencia renal cronica (IRC) en programa de hemodialisis (HD) periodicas durante 21 anos, y que en ese periodo de tiempo desarrollo un cuadro de hiperparatiroidismo secundario grave. La tomografia axial computarizada (TAC) revelo la presencia de multiples tumores pardos que afectaban a escapula, costillas, columna vertebral, huesos pelviano y sacro. El analisis microscopico del tumor pardo mostro la presencia de una densa infiltracion del espacio medular por un tejido fibroblastico reactivo, celulas osteo- clasticas gigantes multinucleadas irregularmente distribuidas, histiocitos cargados de hemosiderina y un marcado incremento de los componentes hematopoyeticos. EnglishSkeletal brown tumours are relatively uncommon, and brown tumours that in- volve multiple bones are considered very rare. We describe a 29-year-old woman with chronic renal failure (CRF) who had undergone hemodialysis for 21 years and developed multiple brown tumours associated with severe secondary hyper- parathyroidism. Computed tomography (CT) revealed multiple brown tumours in- volving scapula, ribs, spine and sacroiliac bone. Microscopic analysis of the brown tumour showed dense infiltration of the marrow space by reactive fibroblastic tis- sue with irregularly distributed multinucleated osteoclastic giants cells and mar- ked increase in hematopoietic elements.
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