Sphenoid sinus brown tumor, hypercalcemia, and blindness: An unusual presentation of primary hyperparathyroidism
✍ Scribed by Schweitzer, Vanessa G. ;Thompson, Norman W. ;McClatchey, Kenneth D.
- Publisher
- Wiley (John Wiley & Sons)
- Year
- 1986
- Weight
- 782 KB
- Volume
- 8
- Category
- Article
- ISSN
- 0148-6403
No coin nor oath required. For personal study only.
✦ Synopsis
This is a first report of primary hyperparathyroidism (HPT) masquerading as a destructive fibrous sphenoid sinus "Brown tumor" associated with progressive blindness and hypercalcemia. Diagnosis of a Brown tumor was delayed despite serial computerized tomography of the head and repeated transnasal and transethmoid sphenoid biopsies demonstrating diffuse fibrosis. Only detection and medical evaluation of hypercalcemia, demonstrating elevation of both serum calcium and C-terminal parathyroid hormone with an elevated chloridelphosphate ratio, prompted neck exploration, thus confirming a solitary left superior parathyroid adenoma. Postoperative normocalcemia occurred synchronously with the return of light perception and the arrest of sphenoid sinus and parasellar erosion. Although maxillary Brown tumors of secondary HPT have been reported, this is the first report of osteitis fibrosa of the sphenoid sinus. Differential diagnosis of an erosive sphenoid lesion with cranial nerve dysfunction, exclusive of inflammatory or vascular disease, should include sarcoidosis, primary and metastatic Presented as a Scientific Poster Presentation, 5th Joint Meeting of the