Brown tumor of the palate and mandible in association with primary hyperparathyroidism

Abstract

Routine biochemical screening has resulted in earlier diagnosis of primary hyperparathyroidism (PHPT) at an asymptomatic or minimally symptomatic stage. This has led to a changing pattern of clinical presentation of PHPT from an overt disease with predominantly skeletal manifestations of the 1970s to a more subtle disease of the 1990s. However, although this is true for the Western population, in the Indian subcontinent, with a vitamin D-deficient population, 1 Harinarayan DV Gupta N Kochupillai N Vitamin D status in primary hyperparathyroidism in India. Clin Endocrinol. 1995; 43: 351 Crossref PubMed Scopus (125) Google Scholar PHPT still has a predominant skeletal presentation. Osteitis fibrosa cystica (OFC), bone cysts, and brown tumors are rare clinical entities in the Western world, but are commonly seen in this part of the world. However, it is being predicted that there may be yet another change in the pattern of presentation of PHPT in the Western population. 2 Silverberg SJ Shane E de la Cruz L et al. Skeletal disease in primary hyperparathyroidism. J Bone Miner Res. 1989; 4: 283 Crossref PubMed Scopus (526) Google Scholar Vitamin D deficiency may become more common because of widespread use of protective sunscreens that block UV light and, with it, PHPT may again become a more symptomatic disease. Therefore, the oral and maxillofacial surgeon must remain aware of these lesions and their association with PHPT. The following report describes a case of PHPT with a brown tumor of the mandible and hard palate; unusual locations even in patients of advanced PHPT.