Article

Cauda equina compression revealing brown tumor of the spine in a long-term hemodialysis patient.

Department of Nephrology and Dialysis, Ibn Rochd University Hospital Center, 20100 Casablanca, Morocco.
Joint, bone, spine: revue du rhumatisme (impact factor: 2.25). 01/2007; 73(6):748-50. DOI:10.1016/j.jbspin.2006.01.011 pp.748-50
Source: PubMed

ABSTRACT Brown tumors, or osteoclastomas, are erosive bony lesions arising as a complication of hyperparathyroidism (HPT). In patients with end-stage renal disease (ESRD), brown tumors are classic skeletal manifestations usually seen in severe forms of secondary HPT. However, involvement of the spine is considered extremely rare. We report a long-term hemodialysis case, in which cauda equina compression developed due to a sacral brown tumor. A decompressive surgery and subtotal parathyroidectomy were indicated to preserve neurologic function, and to ensure remineralization of the lesion. This case illustrates that, though rare, brown tumors should be considered in uremic patients with neurological symptoms. Emergent decompressive surgery is required to remove pressure on neurological structures and to stabilize the spine.

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Keywords

brown tumors
 
cauda equina compression
 
decompressive surgery
 
Emergent decompressive surgery
 
end-stage renal disease
 
erosive bony lesions
 
lesion
 
long-term hemodialysis case
 
neurologic function
 
neurological structures
 
neurological symptoms
 
osteoclastomas
 
rare
 
sacral brown tumor
 
severe forms
 
uremic patients
 

Faissal Tarrass