Challenges in the diagnosis and treatment of brown tumors - Clinical radiological features in a case series and review of the literature

Introduction: brown tumors result from changes in bone metabolism due to primary, secondary, or tertiary hyperparathyroidism. Their significance lies in the increased risk of pathological fractures, pain, disability, and functional limitation they can cause. Case reports and discussion: this case series report presents 3 patients with secondary hyperparathyroidism due to chronic kidney disease (CKD) who had not been diagnosed or treated and had sustained pathological fractures. These cases were presented at a referral hospital in southwestern Colombia. The clinical, radiological, and surgical characteristics are described. Additionally, a critical literature review is conducted on secondary CKD-related hyperparathyroidism to emphasize the importance of diagnostic suspicion, as nearly 1 in 3 patients with advanced-stage CKD will develop secondary hyperparathyroidism, leading to a high risk of pathological fractures associated with significant morbidity.