Primary hyperparathyroidism presenting with a maxillary tumour and hydrocephalus

Abstract

Primary hyperparathyroidism presenting with advanced bone disease is an important differential diagnosis of 'tumours' affecting the craniofacial skeleton. We describe a case of primary hyperparathyroidism presenting with a brown tumour of the maxilla causing local symptoms. Differentiation from other giant cell lesions of the maxilla is necessary. The histological and radiological features of brown tumour, non-ossifying fibroma and reparative granuloma are all similar. Differentiation relies on plasma calcium estimation and the diagnosis of hyperparathyroidism is confirmed by serum parathyroid hormone assay.

Giant cell reparative granuloma of the concha bullosa

“…Since GCRG is histologically identical to the brown tumour of hyperparathyroidism, testing for biochemical abnormalities of hyperparathyroidism is essential to establish a final diagnosis before embarking on any definitive treatment. Treatment of the underlying hyperparathyroidism and control of the hypercalcaemia alone will result in gradual healing of the brown tumour and resolution of the local symptoms (Robinson and Woodhead, 1988).…”