BROWN TUMORS IN THE JAWS AS THE FIRST CLINICAL SIGN OF HYPERPARATHYROIDISM

Abstract

Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up. Brown tumor of hyperparathyroidism is a bone lesion that results from abnormal bone metabolism. Our study describes a case of a 26-year-old man presenting clinically facial deformity and bone expansion in the jaws. Cone-beam computed tomography exhibited an expansive, ill-defined multilocular hypodense lesion in the maxilla, and a well-defined unilocular hypodense lesion in the mandible. Medical history was not contributive. An incisional biopsy was done, and histopathological analysis of both lesions displayed abundant osteoclast-type multinucleated giant cells intermingled with ovoid and spindle-shaped mononuclear cells in a fibrovascular background, suggestive of central giant cell lesions. Laboratory examination revealed elevated serum levels of parathyroid hormone and calcium, and a decreased level of phosphorus. Based on clinical, radiologic, microscopic, and biochemical findings, the diagnosis was brown tumor of hyperparathyroidism. The patient had undergone excision of right lower parathyroid and had a partially significant reduction in the jaws’ tumors after 6 months of follow-up.