Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism

Madiha Mahfoudhi,Mamia Ben Salah,Amel Gaieb Battikh,Rym Lahiani,Turki Sami,Khaled Khamassi

doi:10.4236/ijcm.2015.64031

Madiha Mahfoudhi, Mamia Ben Salah + Show 4 more

Open Access

https://doi.org/10.4236/ijcm.2015.64031

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Abstract

Brown tumor or localized form of osteitis fibrosa cystic is a focal lesion complicating hyperpara-thyroidism. It’s rarely revelatory of the clinical feature and corresponds to a mass with partly cystic and partly solid areas. A 65-year-old man, followed up for hypertension, complained of a progressive swelling in the left paranasal part of the face lasting for 3 months. Physical examination revealed a left paranasal swelling of 4 cm diameter, with a healthy looking skin. CT facial bones found a round formation of 2 cm involving the left maxilla. He received tumor resection by vestibular pathway. Histological examination showed many giant cells. We then discussed the brown tumor diagnosis. The PTH dosage was high: 645 pg/mL (normal: 15 - 68 pg/mL). The serum calcium was in the superior normal limit (100 mg/dL). Cervical ultrasound revealed a bottom left parathyroid nodule. A lower left parathyroidectomy was performed. Histological results confirmed parathyroid adenoma. Monitoring was marked by a marked decrease of the PTH serum level then a return to normal values, a normocalcemia and no recurrence of the maxillary tumor with Recoil of 14 months. Brown tumor of the maxilla is rare and should be considered even in absence of hypercalcemia.

Highlights

Primary hyperparathyroidism is inappropriate secretion of parathyroid hormone (PTH) inducing commonlyHow to cite this paper: Mahfoudhi, M., Khamassi, K., Battikh, A.G., Lahiani, R., Sami, T. and Salah, M.B. (2015) Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism
Brown tumor is the localized form of osteitis fibrosa cystic [5]-[7]
An excess of parathyroid hormone can be complicated of brown tumor corresponding to a reactive lesion in the bone

Summary

Introduction

Primary hyperparathyroidism is inappropriate secretion of parathyroid hormone (PTH) inducing commonly. Primary hyperparathyroidism induces two main complications: bones and kidneys lesions. It leads to renal stones formation or nephrocalcinosis corresponding to diffuse parenchymal calcium deposits [1]. Characteristic skeletal disturbances complicating this disease are essentially osseous resorption, bone cysts, brown tumors and generalized osteopenia. These lesions involve more frequently the ribs, clavicles, pelvic girdle, and the mandible. Brown tumor can be encountered in primary hyperparahyroidism and less frequently in the secondary form. It belongs to giant cells lesions [2]. The aim of this study is to remind clinicians that brown tumors should be considered as rare revealing forms of primary hyperparathyroidism

Case Report

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