Regression of brown tumor of the maxilla in a patient with secondary hyperparathyroidism after a parathyroidectomy

Nabi, Zahid; Algailani, Mohammed; Abdelsalam, Mohamed Said; Asaad, Lina; Albaqumi, Mamdouh

doi:10.1111/j.1542-4758.2010.00436.x

Cited by 20 publications

(17 citation statements)

References 8 publications

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“…23 With regard to follow-up, 35.4% reported an improvement and only 3.9% reported worsened condition. This is probably due to lack of careful reporting or severe cases that were not candidates for surgical intervention.…”

Section: Discussionmentioning

confidence: 91%

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Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report

Baracaldo

Bao

Iampornpipopchai

et al. 2015

Hemodialysis International

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Osteitis fibrosa cystica (OFC) is the most frequent type of osseous change in renal osteodystrophy affecting the majority of dialysis patients. Brown tumors are a severe form of OFC. The involvement of the craniofacial skeleton causing facial disfigurement in patients on dialysis appears to be limited to case reports. After searching PubMed, we performed a systematic review of 127 cases with a severe form of OFC resulting in a facial disfigurement to understand possible determinants for this condition. We found that since the first published case in 1974, and after a peak in 1996, there appears to be an increase in published reported cases. Only 27.6% of these cases were published in nephrology journals. The most common region for reported cases was North America. Mean age of these patients was 31.2 years with a mean dialysis duration of 7 years. Almost 67% were women, and almost all were on hemodialysis. The disease tended to most commonly localize to the maxilla (73.2%) and mandible (57.5%). As part of the treatment, 59% of patients had a parathyroidectomy. More than one-third (35.4%) had symptomatic improvement at follow-up. Mean follow-up was 1.6 years. Clinicians should be aware of this clinical presentation of a severe form of OFC and/or brown tumors. Timely diagnosis and intervention may help to prevent or decrease destructive bone changes and reduce negative psychological consequences of facial disfigurement.

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Section: Discussionmentioning

confidence: 91%

“…20,21 In cases refractory to medical treatment, parathyroidectomy is indicated. 23 In rare circumstances, kidney transplantation can be offered to patients who failed all other therapies. 23 In rare circumstances, kidney transplantation can be offered to patients who failed all other therapies.…”

Section: Introductionmentioning

confidence: 99%

Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report

Baracaldo

Bao

Iampornpipopchai

et al. 2015

Hemodialysis International

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show abstract

Section: Discussionmentioning

confidence: 99%

“…The decrease in size and the healing of such lesions with sclerosis is usually fast after the removal of the parathyroids . PTX isolated was able to halt the progression of the BT in many cases and even lead to its disappearance . Therefore, surgical PTX is considered as the most adequate therapeutic approach in patients with unsatisfactory response to calcitriol, and a progressive regression of the bone tumors is expected .…”

Section: Discussionmentioning

confidence: 99%

Brown tumors in dialyzed patients with secondary hyperparathyroidism: Report of 16 cases

Hamouda

Handous

Dhia

et al. 2012

Hemodialysis International

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Brown tumors (BTs) are relatively uncommon but they are serious complications of renal osteodystrophy. The objective of this study was to analyze the clinical, biological, and radiological characteristics of 16 patients with BTs provoked by secondary hyperparathyroidism (sHPT) and its response to the decrease in parathyroid hormone levels after parathyroidectomy (PTX). The management of that uncommon condition was also reviewed. We conducted a retrospective study including 16 end-stage renal disease patients who underwent subtotal PTX between 1997 and 2007 for severe sHPT with BTs. Our study included 10 men and 6 women, whose average age was 34 years. All patients were on dialysis. Ten of them were on dialysis for more than 5 years. The median duration on dialysis was 84 months. Patients included suffered from swellings associated with functional limitations. BTs had multiple locations in 7 patients. Jaw was the most frequent location (62%). Radiography and tomodensitometry demonstrated a mixed radio lucent and radio-opaque lesions with an expansion of the cortical bone. Bone scan demonstrated an increased uptake of lesions. Chirurgical treatment was indicated in all cases because of severe refractory sHPT with functional limitations and/or disfiguring deformities. In all cases, BTs stopped its progression and even decreased in size. However, it was insufficient in four cases, which required a surgical resection. PTX remains an efficacious approach in resistant cases of sHPT with persistent BTs.

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“…A complete disappearance of the brown tumors has been observed after parathyroidectomy [4, 15]. However, regression of the brown tumors can be incomplete [3, 10].…”

Section: Discussionmentioning

confidence: 99%

Sarcoma-Like Pyogenic Granuloma of the Thumb and Respiratory Restrictive Syndrome in a Non-Compliant Hemodialysis Patient

Simon

Gevenois²,

Marmol³

et al. 2012

Case Rep Nephrol Urol

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Pyogenic granuloma is a benign vascular tumor of the skin or mucosae usually observed after irritative processes. We report the case of a non-compliant hemodialysis patient with severe hyperparathyroidism who rapidly developed growing pyogenic granuloma of the distal part of the left thumb. This tumor mimicked sarcoma and caused recurrent bleeding during hemodialysis sessions. Hand radiograph revealed an osteolytic lesion compatible with a brown tumor. Among other brown tumors, several of those found in the ribs were responsible of a severe respiratory restrictive deficit. This report highlights the difficulty to choose the adequate treatment of severe hyperparathyroidism, and discusses the benefit/risk balance of performing parathyroidectomy.

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Regression of brown tumor of the maxilla in a patient with secondary hyperparathyroidism after a parathyroidectomy

Cited by 20 publications

References 8 publications

Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report

Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report

Brown tumors in dialyzed patients with secondary hyperparathyroidism: Report of 16 cases

Sarcoma-Like Pyogenic Granuloma of the Thumb and Respiratory Restrictive Syndrome in a Non-Compliant Hemodialysis Patient

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