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Asian Spine J > Volume 9(3); 2015 > Article
Ozyurek and Atik: Comments on Brown Tumor of Cervical Spines
Dear Editor,
We enjoyed reading the case report entitled "Brown tumor of the cervical spines: a case report with literature review" by Alfawareh et al. [1]. We would like to commend the authors for their detailed and valuable work.
Brown tumor, an uncommon focal giant cell lesion, is a nonneoplastic and reactive process that occurs due to bone resorption and localized benign clinical osseous lesions appearing as a skeletal manifestation of primary or secondary hyperparathyroidism. Spinal involvement (cervical, thoracic, and lumbar spine) with brown tumor (osteoclastoma) in patients with hyperparathyroidism, although rare, may be the initial manifestation of HPT [12].
However, we believe that some important additional comments are necessary. In the article, the authors stated that there are only four cases of cervical spine involvement reported, three of which are of secondary hyperparathyroidism. Only one reported case involves the axis, the second cervical vertebra, in secondary hyperparathyroidism. To their knowledge, theirs was the first reported case of axis brown tumor due to primary hyperparathyroidism, the second reported case for cervical spine involvement of primary hyperparathyroidism and the fifth reported case of cervical spine brown tumor [1]. Nevertheless, we would like to call the attention of the readers to the fact that the literature contains additional case reports related to cervical spine brown tumor (Table 1) [1234567891011].
Again, we appreciate the work by the authors, which adds to our knowledge of this difficult clinical problem.

Conflict of Interest

Conflict of Interest: No potential conflict of interest relevant to this article was reported.


1. Alfawareh MD, Halawani MM, Attia WI, Almusrea KN. Brown tumor of the cervical spines: a case report with literature review. Asian Spine J 2015;9:110–120. PMID: 25705344.
crossref pmid pmc
2. Ericsson M, Holm E, Ingemansson S, Lindholm T, Svendgaard NA. Secondary hyperparathyroidism combined with uremia and giant cell containing tumor of the cervical spine: a case report. Scand J Urol Nephrol 1978;12:185–187. PMID: 694445.
crossref pmid
3. Graziani N, Donnet A, Antipoff M, Gaborit P, Hassoun , Grisoli F. Recklinhausen brown tumor of the cervical spine disclosing primary hyperparathyroidism. Neurochirurgie 1991;37:394–397. PMID: 1780018.
4. Barlow IW, Archer IA. Brown tumor of the cervical spine. Spine (Phila Pa 1976) 1993;18:936–937. PMID: 8316899.
crossref pmid
5. Ashebu SD, Dahniya MH, Muhtaseb SA, Aduh P. Unusual florid skeletal manifestations of primary hyperparathyroidism. Skeletal Radiol 2002;31:720–723. PMID: 12483435.
crossref pmid
6. Gheith O, Ammar H, Akl A, et al. Spinal compression by brown tumor in two patients with chronic kidney allograft failure on maintenance hemodialysis. Iran J Kidney Dis 2010;4:256–259. PMID: 20622318.
7. Mateo L, Massuet A, Sola M, Perez Andres R, Musulen E, Sanchez Torres MC. Brown tumor of the cervical spine: a case report and review of the literature. Clin Rheumatol 2011;30:419–424. PMID: 20981561.
crossref pmid
8. Szeverényi C, Dezsö B, Deményi T, Csernátony Z. Vertebral brown tumor in childhood (case report). Surg Sci 2011;2:344–347.
9. Resic H, Masnic F, Kukavica N, Spasovski G. Unusual clinical presentation of brown tumor in hemodialysis patients: two case reports. Int Urol Nephrol 2011;43:575–580. PMID: 20424916.
crossref pmid
10. Kerstens MN, de Vries R, Plukker JT, Slart RH, Dullaart RP. Multiple skeletal lesions on FDG PET in severe primary hyperparathyroidism. Eur J Nucl Med Mol Imaging 2014;41:182–183. PMID: 23877635.
crossref pmid
11. Khalatbari MR, Moharamzad Y. Brown tumor of the spine in patients with primary hyperparathyroidism. Spine (Phila Pa 1976) 2014;39:E1073–E1079. PMID: 24921845.
crossref pmid
Table 1

Summary of the previously reported Brown tumor cases related to primary or secondary hyperparathyroidism and their main features



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