PMC8416393_01
Standard X-ray showing a lytic lesion with cortical thinning and pathologic fracture in the left proximal humerus (red arrow).
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fig1
(a) Proliferation of fibroblasts mixed with giant cells (magnification: 100x). (b) Bone infiltration by a brown tumor (magnification: 100x).
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fig2
The anatomopathologic results showed a connective tissue and bone with thinned and rarefied trabeculae surrounded by osteoblasts (Figure 2(a)), associated with numerous multinucleated giant cells and siderophages (Figure 2(b)) compatible with a brown tumor.
Cervical ultrasound showing an oval, well-defined, hypoechoic nodule, with regular contours, measuring 33 * 32 * 18 mm (red arrow).
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fig3
Cervical ultrasonography showed the presence of an oval nodule at the lower left parathyroid lodge that was bilobed, frankly hypoechoic with hypervascular Doppler signal, measuring 33 * 32 * 18 mm (Figure 3).
Cervicothoracic CT scan revealing a hypodense nodule in the posteroinferior pole of the left thyroid lobe (red arrow).
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fig4
The same parathyroid adenoma was located on the cervicothoracic computed tomography scan (Figure 4).
Radiographs showing multiple well-limited osseous lytic lesions with sclerotic margins (red arrows). (a) Ischiopubic ramus. (b) The distal extremity of the femur and the upper end of the tibia.
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fig5
Abdominal CT scan showing bilateral multilocular adrenal masses, with a predominantly fat density (-75 UH), measuring 64 * 59 * 42 mm on the right gland and 102 * 93 * 69 mm on the left gland (red arrows).
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fig6
CT scan of the adrenal glands and pancreas revealed the presence of bilateral adrenal masses, with embossed, multilocular contours, and a predominantly fat density, measuring 64 * 59 * 42 mm on the right gland and 102 * 93 * 69 mm on the left one (Figure 6).
Magnification 100x, showing well-circumscribed tumor proliferation with thin fibrous capsule. Tumor cells are monotonous not atypical (HE: 100x).
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fig7
The anatomopathological results confirmed the diagnosis of parathyroid adenoma without signs of malignancy (Figure 7).
Magnification 100x, showing tumor proliferation of vesicular pattern with capsular invasion (HE: 100x).
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fig8
As for the thyroidectomy specimen, the histological study showed a vesicular carcinoma with capsular effraction and vascular emboli, classified pT3aNxMx (Figure 8), and a lymph node dissection with a radioiodine-131 therapy (RIT) will be scheduled.