MANAGEMENT OF BROWN TUMOR OF THE JAWS IN TERTIARY HYPERPARATHYROIDISM: A CASE REPORT

Maria Eduarda Lanes Baldino,Valesca Sander Koth,Leticia Jacoby,Bethina Dos Santos,Fernanda Salum,Maria Antonia Zancanaro De Figueiredo,Karen Cherubini

doi:10.1016/j.oooo.2019.06.290

Maria Eduarda Lanes Baldino, Valesca Sander Koth + Show 5 more

https://doi.org/10.1016/j.oooo.2019.06.290

Copy DOI

Export

Save

Cite

Abstract
Full-Text
Similar Papers

Abstract

Listen

A 26-year-old white male patient with kidney transplant history (4 months earlier) presented with 2 asymptomatic firm purplish nodules in the mandible causing tooth mobility. Laboratory tests showed serum levels of alkaline phosphatase at 646 U/L and parathyroid hormone at 511.7 pg/mL. Computed tomography showed radiolucent images in the anterior, posterior, and basilar regions of the mandible. Radiographic examination of hand-wrist and pelvis also depicted osteolytic images. Biopsy of the oral lesions was performed, and the histopathologic examination was compatible with central giant cell granuloma. Scintigraphy exhibited hyperfunctional parathyroid, and parathyroidectomy revealed nodular formations, chief cells, oxyphil cells, focal fibrosis, and calcification compatible with parathyroid hyperplasia. The clinical picture confirmed tertiary hyperparathyroidism. Mandible lesions were then subjected to intralesional injections of triamcinolone acetonide (20 mg/mL) and lidocaine (0.5%). After 8 sessions, the lesions had partial remission. The patient is under clinical and radiographic follow-up without any relapse of the disease. A 26-year-old white male patient with kidney transplant history (4 months earlier) presented with 2 asymptomatic firm purplish nodules in the mandible causing tooth mobility. Laboratory tests showed serum levels of alkaline phosphatase at 646 U/L and parathyroid hormone at 511.7 pg/mL. Computed tomography showed radiolucent images in the anterior, posterior, and basilar regions of the mandible. Radiographic examination of hand-wrist and pelvis also depicted osteolytic images. Biopsy of the oral lesions was performed, and the histopathologic examination was compatible with central giant cell granuloma. Scintigraphy exhibited hyperfunctional parathyroid, and parathyroidectomy revealed nodular formations, chief cells, oxyphil cells, focal fibrosis, and calcification compatible with parathyroid hyperplasia. The clinical picture confirmed tertiary hyperparathyroidism. Mandible lesions were then subjected to intralesional injections of triamcinolone acetonide (20 mg/mL) and lidocaine (0.5%). After 8 sessions, the lesions had partial remission. The patient is under clinical and radiographic follow-up without any relapse of the disease.

Full Text