BROWN TUMOR IN A PATIENT WITH PRIMARY HYPERPARATHYROIDISM: A CASE REPORT OF A LESION WITH AN UNUSUAL BEHAVIOR

Abstract

A 33-year-old woman presented with a 2-year history of a large swelling on the right side of the mandible accompanied by chin paresthesia. Intra-oral examination revealed a firm enlargement beneath the normal overlying mucosa in the retromolar region. Panoramic radiograph revealed a multilocular lesion extending from the molar region to the ramus (about 15 cm). A round central radiolucent area was also noted beneath the roots of the incisor teeth. Cone beam computed tomography evaluation revealed an aggressive lesion, with rupture of the cortical plates of both sites. Biopsy revealed connective tissue with large spindle cells, with multinucleated giant cells, a large amount of blood vessels, and woven bone with osteoid deposition. Serologic tests showed altered levels of parathyroid hormone (2.377 pg/mL), alkaline phosphatase (753 U/L), and calcium (12.5 mg/dL). Final diagnosis of brown tumor of hyperparathyroidism was made, and the patient was referred to endocrinology treatment and to intralesional corticoid injection.