Brown Tumor at the Jaw in Patients With Secondary Hyperparathyroidism Due to Chronic Renal Failure

Abstract

Summary: Brown tumors are bony lesions caused by rapid osteoclastic activity, which rare involved jaws. Renal osteodystrophy (ROD) is associated with different pathogenetic mechanisms -disorder of calcium-phosphate metabolism, impaired metabolism of vitamin D, increased parathyroid activity that lead to extreme concentrations of parathormone. The authors report two cases of jaw enlargement in patients received haemodialysis with excessive increase values of alkaline phosphatase and parathormone in serum. The patients were treated surgically with corrective procedures in maxillo-facial area. ROD of the jaws could be severe complication in dialysis patients with end stage of CKD if no appropriate care aimed at correction or prevention of parathyroid hyperfunction was applied to them.

Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism

“…Clinical symptoms caused by brown tumors depend on their location and size; they range from small asymptomatic lesion, discovered accidentally by radiological examination, to a large locally destructive lesion resulting in a variety of symptoms that are mostly related to facial deformation and disfiguration, such as difficulty in chewing, talking, and breathing. Intraorally, it presents as an expansile bone lesion (localized or diffuse); it causes abnormal occlusion due to mobility and displacement of teeth in the affected region [24,25].…”

Brown Tumors: A Case Report and Review of the Literature

“…Brown tumors may cause facial disfiguration and compromise social ease of the patient and normal functions, such as chewing, talking, and breathing. Other complications include headaches, visual impairment, proptosis of the eyes, displacement and mobility of the teeth, and nasal or intraoral bleeding [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. The huge tumor in our case originated from the mandible and caused teeth to fall out and severely affected chewing.…”

Mandibular Brown Tumor of Secondary Hyperparathyroidism Requiring Extensive Resection: A Forgotten Entity in the Developed World?

“…Unlike primary HPT, secondary HPT is typically associated with serum hypocalcemia and hyperphosphatemia [ 5 , 7 ]. Patients with chronic kidney disease display renal osteodystrophy, which can result in bone loss, bone pain, and fractures [ 17 ].…”