The Effect of Teriparatide in a Brown Tumor Patient With Pathological Hip Fracture: A Case Report and Literature Review.

Dalia Abdel-Hadi, Ali Al Lawati, Ahmed Al Farkani, Yahya Al Badaai, Humaid Al Farii

Journal: JBJS case connector 2026;16(3):

PMID: 42462050

Abstract

CASE

A 32-year-old man with end-stage renal disease (ESRD) from anti-neutrophil cytoplasmic antibody-associated vasculitis and tertiary hyperparathyroidism, presented with progressive right hip pain. A giant cell-rich lesion biopsy confirmed Brown tumor. Despite cinacalcet and vitamin D, hyperparathyroidism persisted, necessitating parathyroidectomy complicated by hungry bone syndrome and a pathological right hip fracture. Surgical fixation and prosthetic replacement were deferred due to high risk factors such as, ESRD and fracture pattern, as well as potential for postoperative implant failure and infection. Teriparatide was initiated to promote bone remodeling, leading to pain relief and radiographic improvement.

CONCLUSION

To our knowledge, this is the first reported long-bone Brown tumor successfully treated with teriparatide.

Address: Department of Surgery, Orthopaedic division, Sultan Qaboos University Hospital, Muscat, Oman.; Division of Nephrology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.; Division of Endocrinology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.; Department of Otolaryngology-Head and Neck Surgery, Sultan Qaboos University Hospital, Muscat, Oman.

DOI: 10.2106/JBJS.CC.25.00667

MeSH Terms: Humans, Male, Teriparatide, Bone Density Conservation Agents, Adult, Hip Fractures, Osteitis Fibrosa Cystica, Kidney Failure, Chronic, Fractures, Spontaneous