Secondary hyperparathyroidism associated with multiple brown tumor: a case report

Li, Kangfeng; Zhou, C.; Zhao, Xiaona; Zhou, Yukun; Zhang, Dechang; Yang, Guanhu; Tang, Xiaofang

doi:10.1016/s1000-1948(12)60032-x

Cited by 4 publications

(8 citation statements)

References 7 publications

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“…However, few authors consider the etiological approach as the unique gold standard for treatment sufficient to provoke the spontaneous regression of the tumor. 3,15,26 Regarding primary HPTH, etiological treatment consists of reversing hypercalcemia via parathyroidectomy (paraX), which usually induces the spontaneous sclerosis and regression of the tumor. 3,15,27 In our study, paraX was performed on 4 PHPTH patients out of 6.…”

Section: Discussionmentioning

confidence: 99%

Brown Tumors of the Jaws: A Retrospective Study

Fedhila,

Belkacem Chebil,

Marmouch

et al. 2023

Clin Med Insights Endocrinol Diabetes

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Objectives: (1) Describe the clinical spectrum, imaging features, management, and outcome of brown tumors (BT) of the jaws. (2) Determine via a literature review the facts and controversies around the characteristics and management of this lesion. Materials and methods: Our study was approved by the institutional committee of Sahloul University Hospital in accordance with the ethical standards of the Declaration of Helsinki. Sixteen patients with BT in the context of a primary, secondary, and tertiary hyperparathyroidism were treated and followed up during their recovery. Results: This study reports 16 patients with a mean age of 48 years old. Brown tumor lesions were associated with primary hyperparathyroidism in 6 cases (38%), secondary hyperparathyroidism to chronic kidney failure in 5 cases (31%), and tertiary hyperparathyroidism in the context of a long lasting CRI in 5 cases. Their location was maxillary in 7 cases, mandibular in 5 cases, and bimaxillary in 4 cases. The treatment consisted of parathyroidectomy in 13 patients, maxillary resection in 3 cases, and vitamin D treatment in 2 cases. Favorable outcomes, characterized by tumor regression, were reported in 9 cases, whereas unfavorable evolution was observed among 7 patients. Conclusion: Parathyroidectomy is the gold standard treatment for primary hyperparathyroidism. It resulted in a total regression in all our cases. Regarding secondary hyperparathyroidism, blood screening and chronic renal insufficiency follow-up are critically valuable to detect this condition at an early stage, hence increasing the success rate of brown tumor regression. Our secondary and tertiary hyperparathyroidism results were miscellaneous; although it is important to emphasize the importance of the chronic renal insufficiency management to ensure a success. Clinical relevance: Brown tumors should be included in the differential diagnosis of giant cell lesions. Parathyroidectomy is usually sufficient to induce the total regression of the lesion in primary hyperparathyroidism cases. A more delicate approach is needed regarding secondary hyperparathyroidism. Meticulous control of chronic renal insufficiency is mandatory in addition to parathyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Brown Tumors of the Jaws: A Retrospective Study

Fedhila,

Belkacem Chebil,

Marmouch

et al. 2023

Clin Med Insights Endocrinol Diabetes

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“…Anyway, even in primary, secondary or tertiary cases, regression or complete remission of the lesions has been reported . Some authors recommend only the treatment of the endocrine and/or renal disturbance to allow the progressive sclerosis of the compromised bone . Surgical excision would be indicated only when the lesion does not respond to hyperparathyroidism treatment or in case of significant functional compromise, because the resolution of the lesion can take months to years .…”

Section: Discussionmentioning

confidence: 99%

“…Primary hyperparathyroidism is associated with parathyroid adenoma (80% of cases), gland hyperplasia (15 to 20%), or carcinoma (less than 0.5%) . Usually, in the secondary type, PTH secretion occurs in response to low serum levels of calcium and vitamin D in patients with chronic renal insufficiency (CRI) . The tertiary type, first described in 1963, is the rarest form and affects patients with long‐lasting secondary hyperparathyroidism, who because of renal insufficiency develop autonomous functioning of the parathyroid with PTH hypersecretion .…”

Section: Brown Tumor Of Hyperparathyroidismmentioning

confidence: 99%

“…Brown tumor represents a tissue repair process that results from the PTH effect, which induces bone tissue replacement with vascularized fibrous connective tissue . PTH also leads to conversion of cell osteogenic potential to osteoclasts, and consequent predominance of bone resorption over bone neoformation . Hypocalcemia, hyperphosphatemia, and calcitriol deficiency of CRI determine the increase in PTH, At sites where bone resorption rates are particularly greater, hemorrhage, granulation tissue, and fibrous connective tissue proliferation can replace the normal content of bone marrow, resulting in brown tumor …”

Section: Brown Tumor Of Hyperparathyroidismmentioning

confidence: 99%

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Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report

Santos

Koth

Figueiredo

et al. 2018

Special Care in Dentistry

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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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“…Secondary hyperparathyroidism occurs due chronic renal failure that leads to an excessive secretion of parathyroid hormone (PTH) by the parathyroid glands in response to hypocalcaemia, hyperphosphatemia and hypertrophy of those glands [3]. These lesions develop mainly on the maxillomandibular complex, usually presented a s wel l-def i ned lesions, ci rcu mscribed a nd osteolytic [9].…”

Section: Introductionmentioning

confidence: 99%

Bilateral maxillary osteoplasty with esthetic purpose in patient with secondary hyperparathyroidism-related brown tumor: case report

Wastner¹,

Ferreira²,

Schussel³

et al. 2016

RSBO

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To report a case of a patient with secondary hyperparathyroidism that developed brown tumour in bilateral maxilla surgically managed with bilateral osteoplasty for aesthetic reasons. Case report: A 46 years-old woman patient with chronic kidney disease with complain of a painless bilateral growth on the maxilla, beginning 10 years before that ceased after surgical removal of the parathyroid eight years before. A CT scan showed a diffuse and heterogeneous bone lesion, with lytic areas and increased multilobulated volume on the maxilla, bilaterally. The surgery was an osteoplasty of the maxilla bone and performed under general anaesthesia. At 16-month follow-up, no recurrence was observed and the patient is satisfied with aesthetic and functional results. Conclusion: Secondary hyperparathyroidism related with oral brown tumour is a rare condition that affects function and aesthetic. The case reported in this paper was appropriately managed, achieving patient expectation and improving her life quality.

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Secondary hyperparathyroidism associated with multiple brown tumor: a case report

Cited by 4 publications

References 7 publications

Brown Tumors of the Jaws: A Retrospective Study

Brown Tumors of the Jaws: A Retrospective Study

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report

Bilateral maxillary osteoplasty with esthetic purpose in patient with secondary hyperparathyroidism-related brown tumor: case report

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