Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland

Ávila, Érica Dorigatti de; Molon, Rafael Scaf de; Gabrielli, Marisa Aparecida Cabrini; Hochuli‐Vieira, Eduardo; Massucato, Elaine Maria Sgavioli; Mello-Filho, Francisco Veríssimo; Conti, Luis Carlos

doi:10.1016/j.jcms.2011.01.001

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…[8,11] Prevalence in patients with tertiary HPT is unknown and has rarely been reported. [10,[12][13][14][15][16] Our systematic review of the medical literature yielded 95 cases (published from 1962 through 2020) of craniofacial brown tumors. Table 2 summarizes the results of the literature review.…”

Section: Craniofacial Brown Tumormentioning

confidence: 99%

Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

et al. 2020

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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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Section: Craniofacial Brown Tumormentioning

confidence: 99%

Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

et al. 2020

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“…Of the five reported cases of craniofacial brown tumours of tertiary hyperparathyroidism,4 7–10 only one records occurrence in a renal transplant recipient 4…”

Section: Discussionmentioning

confidence: 99%

Rare brown tumour of the mandible secondary to tertiary hyperparathyroidism in a renal transplant recipient

Guéroult

Cameron

2019

BMJ Case Rep

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Brown tumours are rare osteolytic lesions that occur secondary to hyperparathyroidism (HPT). In 2% of all cases, the craniofacial bones are affected, most frequently the mandible. HPT is classified according to aetiology into three types, of which tertiary HPT is the rarest. Here we present the case of a 42-year-old man who had received a renal transplant 16 years previously and was referred due to swelling on the right side of his jaw. An orthopantomogram revealed a multilocular radiolucency in the right body of the mandible. The bony lesion was treated by surgical enucleation. After histopathological examination of the lesion, the diagnosis of brown tumour of the mandible secondary to tertiary HPT was reached. The patient’s recovery was uneventful and follow-up radiography showed good bone healing.

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“…[32][33][34][35] These symptoms are typically referred for treatment to specialties of maxillofacial surgery, oral surgery, reconstructive and plastic surgery, ENT, ophthalmology, and dentistry. The lesions from OFC and BT are not painful and often produce symptoms, depending on the location of facial asymmetry, oral mass, nasal obstruction, sinusitis, progressive visual disturbances, proptosis, chewing diffi-culties, hearing abnormalities, and airway obstruction in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…The lesions from OFC and BT are not painful and often produce symptoms, depending on the location of facial asymmetry, oral mass, nasal obstruction, sinusitis, progressive visual disturbances, proptosis, chewing diffi-culties, hearing abnormalities, and airway obstruction in the pediatric population. [32][33][34][35] These symptoms are typically referred for treatment to specialties of maxillofacial surgery, oral surgery, reconstructive and plastic surgery, ENT, ophthalmology, and dentistry. These specialties expressed interest in the disease and reported case studies in the literature.…”

Section: Discussionmentioning

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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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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Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland

Cited by 12 publications

References 9 publications

Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

Rare brown tumour of the mandible secondary to tertiary hyperparathyroidism in a renal transplant recipient

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

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