Abstract
A 51 years maintenance dialysis patient with recent history of kidney graft failure was found to have bone mass on his left hip on CT scan one year after nefrectomy for renal cell carcinoma. The diagnosis of bone metastasis was done and only palliative care was ordered.
Two years later, the bone mass progressed, but clinical picture of the patient was good. Thus, patient himself together with his nephrologist, questioned the diagnosis.
Due to necessity of living expectance assessment before pacemaker implantation, bone biopsy from the affected bone was done. Histology finding confirmed the "brown tumor", bone lesion associated with advanced hyperparathyroidism.
Several surgical procedures were necessary to remove all autonomic parathyroid glands. Finally, after great improvement of subjective bone pain the patients was successfully re-transplanted.
The differential diagnosis of bone tumor mass in dialysis patients is difficult. It must include also the non-malignancy etiology, as in this case.