Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism

Abstract

Brown tumor or localized form of osteitis fibrosa cystic is a focal lesion complicating hyperparathyroidism. It's rarely revelatory of the clinical feature and corresponds to a mass with partly cystic and partly solid areas. A 65-year-old man, followed up for hypertension, complained of a progressive swelling in the left paranasal part of the face lasting for 3 months. Physical examination revealed a left paranasal swelling of 4 cm diameter, with a healthy looking skin. CT facial bones found a round formation of 2 cm involving the left maxilla. He received tumor resection by vestibular pathway. Histological examination showed many giant cells. We then discussed the brown tumor diagnosis. The PTH dosage was high: 645 pg/mL (normal: 15 -68 pg/mL). The serum calcium was in the superior normal limit (100 mg/dL). Cervical ultrasound revealed a bottom left parathyroid nodule. A lower left parathyroidectomy was performed. Histological results confirmed parathyroid adenoma. Monitoring was marked by a marked decrease of the PTH serum level then a return to normal values, a normocalcemia and no recurrence of the maxillary tumor with Recoil of 14 months. Brown tumor of the maxilla is rare and should be considered even in absence of hypercalcemia.

Brown tumor of the mandible - a possible clinical manifestation of primary hyperparathyreoidism

“…Due to the rare occurrence of bone manifestations of primary hyperparathyroidism, especially as the first sign 4 , it is hard to distinguish PHPT bone changes from other osteolytic lesions. We describe a case of primary hyperparathyroidism in which the first clinical manifestation of the disease was brown tumor of the mandible.…”