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Guimarães LM, Valeriano AT, Rebelo Pontes HA, Gomez RS, Gomes CC. Manifestations of hyperparathyroidism in the jaws: Concepts, mechanisms, and clinical aspects. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:547-555. [PMID: 35181256 DOI: 10.1016/j.oooo.2021.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/07/2021] [Accepted: 08/22/2021] [Indexed: 11/18/2022]
Abstract
Hyperparathyroidism is one of the most common endocrine disorders worldwide. In countries where routine biochemical screening is not common, symptomatic hyperparathyroidism predominates. Its manifestations include skeletal alterations, calcification of soft tissues, kidney stones, and functional alterations in other systems. Notably, jaw alterations can be the first clinical sign of hyperparathyroidism, including brown tumor, renal osteodystrophy, osteitis fibrosa, and leontiasis ossea, and knowing such conditions is of core importance for the multidisciplinary diagnosis and management of hyperparathyroidism. We aimed to perform a concise review, systematizing the concepts and mechanisms underlying hyperparathyroidism and associated gnathic alterations. In addition, a detailed description of the clinical aspects of the jaw manifestations is presented.
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Affiliation(s)
- Letícia Martins Guimarães
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alline Teixeira Valeriano
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Cavalieri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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2
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Limongelli L, Tempesta A, Lauritano D, Maiorano E, Ingravallo G, Favia G, Capodiferro S. Peripheral Giant Cell Granuloma of the Jaws as First Sign of Primary Hyperparathyroidism: A Case Series. J Clin Med 2020; 9:jcm9124042. [PMID: 33327593 PMCID: PMC7765060 DOI: 10.3390/jcm9124042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 01/14/2023] Open
Abstract
Peripheral giant cell granulomas (PGCG) associated with hyperparathyroidism (HPT) are rare clinical entities. The aim of this study is to report on 21 PGCGs of the oral cavity as the first clinical sign of unknown primary HPT (PHPT) referred to the Complex Operating Unit of Odontostomatology of Aldo Moro University of Bari from 2009 to 2019. Surgical treatment consisted in conservative enucleation of the lesion, if possible, with contextual bone rim osteoplasty with piezosurgical tools and following histological examination. After histological diagnosis of PGCG, PHPT screening was performed dosing parathyroid hormone and serum calcium. In all the patients haematological investigation demonstrated elevated values of parathyroid hormone and serum calcium ruling out an unknown PHPT. Specifically, after endocrinological evaluation, patients showed PHPT related to: parathyroid adenoma (13), parathyroid hyperplasia (two, one of which occurred in a intra-thyroidal parathyroid), and parathyroid carcinoma (1) and were scheduled for surgical treatment. Considering that PGCGs could represent the first clinical sign of an undiagnosed PHPT and the screening of PHPT is a non-invasive and cheap exam, in case of histological diagnosis of a giant cell lesion, both central and peripheral, especially in patients with synchronous or history of methacronous giant cell lesions, parathyroidal screening should be mandatory.
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Affiliation(s)
- Luisa Limongelli
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
- Correspondence: ; Tel.: +39-339-879-0106
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
| | - Dorina Lauritano
- Centre of Neuroscience of Milan, Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy; (E.M.); (G.I.)
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, 70124 Bari, Italy; (E.M.); (G.I.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70124 Bari, Italy; (A.T.); (G.F.); (S.C.)
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3
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Psaila A, Conti L, Azzopardi AP, Coppini DV. A brown tumor secondary to hyperparathyroidism in the maxilla, skull, scapula, and femora. Proc (Bayl Univ Med Cent) 2020; 34:163-165. [PMID: 33456187 DOI: 10.1080/08998280.2020.1826260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Primary hyperparathyroidism presenting with diffuse skeletal involvement, such as discrete osteoclastic bone lesions, is rare. We describe a 35-year-old woman who presented with a left mandibular mass that rapidly enlarged over 3 weeks. Radiological, histological, and biochemical investigations led to the diagnosis of brown tumor secondary to primary hyperparathyroidism. A neck ultrasound revealed a 1.5 × 2.3 × 4.6 cm mass at the lower pole of the left thyroid lobe, suggestive of a parathyroid adenoma. Bone scan showed additional abnormal foci of increased uptake in the maxilla, both femora, skull, and scapula. Brown tumors are treated primarily by correcting the underlying endocrine disorder, and a parathyroidectomy was performed.
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Affiliation(s)
- Alison Psaila
- Department of Endocrinology, Diabetes, and General Medicine, Mater Dei Hospital, Msida, Malta
| | - Luca Conti
- Department of Respiratory and General Medicine, Mater Dei Hospital, Msida, Malta
| | | | - David V Coppini
- Department of Endocrinology, Diabetes, and General Medicine, Mater Dei Hospital, Msida, Malta
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Bransky N, Iyer NR, Cannon SM, Tyan AH, Mylavarapu P, Orosco R, Hom DB, Moazzam AA. Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome. J Bone Metab 2020; 27:217-226. [PMID: 32911586 PMCID: PMC7571245 DOI: 10.11005/jbm.2020.27.3.217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/02/2020] [Indexed: 12/27/2022] Open
Abstract
A 48-year-old woman in her 40’s with end-stage renal disease and tertiary hyperparathyroidism (HPT) presented for a rapidly progressive maxillary tumor. Initial workup was notable for elevated intact parathyroid hormone (PTH) and diffuse thickening of skull and facial bones on computed tomography, and maxillary tumor biopsy with multinucleated giant cells. She underwent subtotal parathyroidectomy (with removal of a parathyroid adenoma and 2 hyperplastic glands) and partial resection of maxillary brown tumor. The patient’s post-operative course was complicated by hungry bone syndrome, with hypocalcemia refractory to aggressive calcium repletion. Teriparatide (recombinant PTH) was utilized with rapid resolution of hypocalcemia. To our knowledge, this is the first case of maxillary brown tumor in tertiary HPT to be reported in the USA. This case also supports teriparatide as a novel therapeutic for hungry bone syndrome refractory to aggressive calcium repletion.
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Affiliation(s)
- Natalie Bransky
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
| | - Neena Ramesh Iyer
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
| | | | | | - Praneet Mylavarapu
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
| | - Ryan Orosco
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
| | - David Brain Hom
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
| | - Alan Ali Moazzam
- Division of Hospital Medicine, UC San Diego Medical Center, San Diego, CA, USA
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5
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Gosavi S, Kaur H, Gandhi P. Multifocal osteolytic lesions of jaw as a road map to diagnosis of brown tumor of hyperparathyroidism: A rare case report with review of literature. J Oral Maxillofac Pathol 2020; 24:S59-S66. [PMID: 32189907 PMCID: PMC7069142 DOI: 10.4103/jomfp.jomfp_319_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/10/2020] [Indexed: 11/04/2022] Open
Abstract
Brown tumor is unifocal or multifocal bone disease which represents terminal stage of hyperparathyroidism (HPT)-dependent bone pathology. It is recognized as a component of metabolic bone disease called osteitis fibrosa cystica generalisata or Von Recklinghausen disease of bone. HPT was first described by Von Recklinghausen in 1891. Brown tumor diagnosis nowadays is less frequently encountered because of early stage detection of HPT. This early detection is possible due to routine blood screening in asymptomatic adults or during evaluation of osteoporosis. Histologically, it may resemble any other giant cell lesion of the jaw that imposes diagnostic challenge and delay in treatment. We are introducing a case report of a 30-year-old female patient presented with multifocal osteolytic lesions in mandible with histopathology depictive of giant cell granuloma. Further biochemical investigations and X-ray skeletal changes raised the suspicion of primary HPT which was confirmed by parathyroid scintigraphy revealing parathyroid adenoma. The main purpose of this case report is to reinforce the role of oral examination in diagnosis of systemic diseases and to propose a diagnostic layout/algorithm when giant cells are present in biopsy specimen. Review of literature showing brown tumor of oral cavity associated with PHPT is discussed.
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Affiliation(s)
- Suchitra Gosavi
- Department of Oral Pathology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Harpreet Kaur
- Division of Oral Pathology, Centre of Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Pramod Gandhi
- Department of Endocrinology and Diabteology, Kingsway Hospitals, Nagpur, Maharashtra, India
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6
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Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism. Adv Med 2020; 2020:6836123. [PMID: 32695835 PMCID: PMC7368230 DOI: 10.1155/2020/6836123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 06/05/2020] [Accepted: 06/22/2020] [Indexed: 11/17/2022] Open
Abstract
Parathyroid glands secrete the parathyroid hormone that plays an essential role in bone remodeling. Excessive production of parathyroid hormone causes a common metabolic bone disorder known as hyperparathyroidism that is classified into primary, secondary, or tertiary. In hyperparathyroidism, the late bony complication is manifested as a giant cell osteolytic lesion called "brown tumor." Primary hyperparathyroidism is usually a sporadic disorder, but in minority of cases it occurs in inherited forms, and one of these forms is the hyperparathyroidism-jaw tumor syndrome, which is characterized by primary hyperparathyroidism and ossifying fibroma in the mandible and/or maxilla.
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7
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Manjunatha BS, Purohit S, Harsh A, Vangala N. A complex case of brown tumors as initial manifestation of primary hyperparathyroidism in a young female. J Oral Maxillofac Pathol 2019; 23:477. [PMID: 31942141 PMCID: PMC6948047 DOI: 10.4103/jomfp.jomfp_166_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Brown tumor is one of the lesions that develop in patients with hyperparathyroidism (HPT) and represents the terminal stages of bone remodeling process. Any of the skeletal bones can be affected including the craniomaxillofacial ones. Many a times, brown tumor was detected after a final diagnosis of HPT is made. However, on occasions, brown tumor can be the first clinical sign of the disease. Primary HPT is an uncommon systemic disease usually caused by hyperplasia or adenoma of the parathyroid glands. It causes overproduction of parathormone, which may affect the entire skeleton, causing bone resorption appear as cyst-like lesions called osteitis fibrosa cystica or brown tumors. Here, we report such a rare case in which multiple radiolucent lesions were noticed in the ramus part of the mandible and premolar region bilaterally, as the initial signs of primary HPT are presented in this report.
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Affiliation(s)
- Bhari Sharanesha Manjunatha
- Department of Oral Biology, Basic Oral Medicine and Allied Dental Sciences Division, College of Dentistry, Al-Hawaiya, AtTaif, Taif University, Taif, Saudi Arabia
| | - Sharad Purohit
- Department of Oral Pathology and Microbiology, Haldia Institute of Dental Sciences and Research, Halda, West Bengal, India
| | - Ashutosh Harsh
- Department of Dentistry, Jhalawar Medical College and Hospital, Jhalawar, Rajasthan, India
| | - Nagamahita Vangala
- Department of Oral Pathology and Microbiology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
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8
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Spontaneous and Excellent Healing of Bilateral Brown Tumors in Mandible after Endocrinal Therapy and Subtotal Parathyroidectomy: Case Report with 4-Year Follow-Up. Case Rep Dent 2018; 2018:8070131. [PMID: 30057827 PMCID: PMC6051251 DOI: 10.1155/2018/8070131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/06/2018] [Indexed: 01/05/2023] Open
Abstract
Primary hyperparathyroidism is an endocrine disorder occurring due to increased secretion of parathormone resulting in a complex of clinical, anatomical, and biochemical alterations. On the other hand, excision of a parathyroid adenoma can normalize the metabolic status. A 24-year-old man was referred to the hospital with bilateral swelling and spontaneous gingival bleeding from posterior of the mandible also with radiolucent well-demarcated lesions bilaterally in the mandibular third molar regions. After consultations, the patient was hospitalized in the endocrinology department where further tests were performed due to highly increased PTH level as 714 pg/ml. Bilateral brown tumors started to regress spontaneously, and no additional surgery was required after subtotal parathyroidectomy was performed. The presented case is the first patient whose bilateral brown tumors in the jaws spontaneously and totally healed after subtotal parathyroidectomy and endocrinal therapy who was strictly followed up for 4 years even though the lesions were associated with impacted third molars.
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9
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Dos Santos B, Koth VS, Figueiredo MA, Salum FG, Cherubini K. Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report. SPECIAL CARE IN DENTISTRY 2018; 38:163-171. [PMID: 29603323 DOI: 10.1111/scd.12284] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant-cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand-wrist, pelvis, and femur. We present here a brief literature review focusing on the clinical and radiographic features, diagnostic criteria and treatment of brown tumor and also report a case of the disease affecting the jaw.
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Affiliation(s)
- Bethina Dos Santos
- Dental College, Pontifical Catholic University of Rio Grande do Sul-PUCRS
| | - Valesca Sander Koth
- Postgraduate Program, Dental College, Pontifical Catholic University of Rio Grande do Sul-PUCRS
| | | | | | - Karen Cherubini
- Postgraduate Program, Dental College, Pontifical Catholic University of Rio Grande do Sul-PUCRS
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10
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An Endocrine Jaw Lesion: Dentist Perspective in Diagnosis. Case Rep Dent 2016; 2016:2582038. [PMID: 27974979 PMCID: PMC5126398 DOI: 10.1155/2016/2582038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 09/26/2016] [Indexed: 11/17/2022] Open
Abstract
Brown tumor is a rare nonneoplastic focal giant cell lesion that occurs in hyperparathyroidism patients with a prevalence rate of 0.1% in jaws. We report an extremely rare case of brown tumor in mandible of a 40-year-old female patient that presented as the first clinical manifestation of hyperparathyroidism. Dentist played a pivotal role in the present case by the early diagnosis of lesion and its intervention.
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11
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Agnihotri M, Kothari K, Naik L. Ω Brown tumor of hyperparathyroidism. Diagn Cytopathol 2016; 45:43-44. [PMID: 27863154 DOI: 10.1002/dc.23631] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/05/2016] [Accepted: 10/12/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Mona Agnihotri
- Department of Pathology, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Kanchan Kothari
- Department of Pathology, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Leena Naik
- Department of Pathology, Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
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12
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Abstract
We present a case of a 75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. The MRI demonstrated marked loss of signal intensity on T2 gradient-echo images, suggesting intralesional hemossiderin. After an open biopsy, histology was consistent with "brown tumor." The finding of susceptibility on T2 gradient-echo images in a mandible lesion adds considerable specificity to the differential diagnosis.
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13
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Mendes PHC, de Melo Filho MR, dos Santos LAN, Dourado MDR, Macedo CP, Cardoso CM, Coletta RD, Martelli Júnior H. Symptomatic swelling on the lingual surface of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:546-550. [DOI: 10.1016/j.oooo.2013.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/03/2013] [Accepted: 04/21/2013] [Indexed: 01/10/2023]
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Altay C, Erdoğan N, Eren E, Altay S, Karasu S, Uluç E. Computed tomography findings of an unusual maxillary sinus mass: brown tumor due to tertiary hyperparathyroidism. J Clin Imaging Sci 2014; 3:55. [PMID: 24404414 PMCID: PMC3883272 DOI: 10.4103/2156-7514.122325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 09/19/2013] [Indexed: 12/02/2022] Open
Abstract
Brown tumor is a non-neoplastic bone lesion that develops secondary to hyperparathyroidism and it is very rare in the maxillofacial region. We report the case of a 59-year-old man who presented with pain and a swelling in the left cheek. Computed tomography (CT) demonstrated an expansile and radioluscent lesion in the left maxillary sinus. Incisional biopsy was performed, and the diagnosis was Brown tumor. Brown tumor must be considered in the differential diagnosis of expansile lesions of maxillary sinus.
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Affiliation(s)
- Canan Altay
- Department of Radiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - Nezahat Erdoğan
- Department of Radiology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Erdem Eren
- Department of Otorhinolaryngology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Sedat Altay
- Department of Radiology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Sebnem Karasu
- Department of Radiology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
| | - Engin Uluç
- Department of Radiology, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
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Gouvêa AF, Díaz KP, Léon JE, Vargas PA, de Almeida OP, Lopes MA. Nodular lesion in the anterior hard palate. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:154-9. [PMID: 22769404 DOI: 10.1016/j.oooo.2011.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 10/26/2011] [Accepted: 11/03/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Adriele Ferreira Gouvêa
- Department of Oral Diagnosis, Oral Semiology and Oral Pathology Sections, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Selvi F, Cakarer S, Tanakol R, Guler SD, Keskin C. Brown tumour of the maxilla and mandible: a rare complication of tertiary hyperparathyroidism. Dentomaxillofac Radiol 2009; 38:53-8. [PMID: 19114425 DOI: 10.1259/dmfr/81694583] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. Brown tumours are one of the bony complications of hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, an extremely rare case of a 19-year-old male patient with brown tumours in his maxilla and mandible associated with tertiary hyperparathyroidism is presented. A thorough diagnostic work-up was carried out and treatment options for both hyperparathyroidism and brown tumours were discussed. The importance of different radiological evaluation methods and the consultation between the oral and maxillofacial surgeons, general practitioner dentists, endocrinologists and radiologists are emphasised.
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Affiliation(s)
- F Selvi
- Istanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.
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17
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Choi C, Terzian E, Schneider R, Trochesset DA. Peripheral giant cell granuloma associated with hyperparathyroidism secondary to end-stage renal disease: a case report. J Oral Maxillofac Surg 2008; 66:1063-6. [PMID: 18423303 DOI: 10.1016/j.joms.2007.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 10/08/2007] [Accepted: 11/11/2007] [Indexed: 11/19/2022]
Affiliation(s)
- Christopher Choi
- Division of Oral and Maxillofacial Surgery, Long Island Jewish Medical Center, New Hyde Park, NY, USA
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