Pimary hyperparathyroidism as central giant cell granuloma of the jaws: Pre- and post-treatment pattern of clinical and radiographic presentation

Abstract

Introduction: The parathyroid glands regulate serum calcium and phosphorous levels by its secretion and maintenance, within physiological limits, of its hormone parathormone (PTH). Hyperparathyroidism is a metabolic disorder resulting from excessive secretion of parathyroid hormone. Hyper secretion might occur either due to a primary pathology in the glands (or) due to secondary causes. Central giant cell lesions occur in jaw bones. Case Report: A 20­year­old boy reported with complaints of swelling in left maxilla. Intra orally swelling extended from left upper canine till left upper second premolar and caused expansion of the cortical plates. Intra oral radiograph and orthopantomograph showed a poorly defined radiolucent lesion in between left upper canine and left upper 1st premolar with multiple cystic cavities in the region of the symphysis, left body and right angle of mandible. The radiographs of long bones showed osteoporosis. Serum alkaline phosphatase level was raised. Histopathology was reported as central giant cell granuloma. Nuclear scan of parathyroid showed a functioning parathyroid adenoma. The swelling in left maxilla regressed on its own after the adenoma of the parathyroids was excised. Conclusion: Timely diagnosis of parathyroid adenoma results in total regression of intra oral swelling and further progression of osteoporosis and fractures of long bones can be prevented.