A clinical case of difficulties in differential diagnosis of bone metastases in breast cancer with "brown" tumors (giant cell tumors) and uncontrolled (asymptomatic) primary hyperparathyroidism
The article presents a clinical case of a patient with breast cancer (BC), with multiple foci of osteolytic destruction of a secondary nature, which was regarded as metastases (mts), were detected in SCT 1.5 years after radical mastectomy and hysterectomy. A course of radiation therapy was carried out, but we were embarrassed that the contours of the destructive foci were clear, shape was correct an in the majority ovoid, less often spherical, that is not typical for mts. A trephine biopsy of ilium excludes a metastatic process: the histological conclusion is a giant cell tumor (GCT), but the polyostotic form is rare. Subsequently, GCT was also excluded - primary hyperparathyroidism (PHPT) was detected due to parathyroid adenoma (PTА). The difficulty of differential diagnosis is that the histological picture fluctuates between GCT and fibrocystic changes in PHPT.