Brown tumor of secondary hyperparathyroidism: surgical approach and clinical outcome

Abstract

The aim of this paper is to describe the case of a 53-year-old female patient, with renal failure who has been on dialysis for 6 years and developed severe secondary hyperparathyroidism and brown tumor of the maxilla and mandible, confirmed by incisional biopsy. Parathyroidectomy was indicated as a result of rapid growth of the tumor and the maintenance of laboratory findings. Despite the normalization of serum parathyroid hormone and alkaline phosphatase, tumor regression was slow and patient's important functional and esthetic deficits persisted. Excision of the mandible tumor was conservative. Osteoplasty was recommended because during a 5-year follow-up there was regression of the lesion, decreased pain, bleeding, and tooth mobility.

Bilateral Brown Tumors of Maxilla with Primary Hyperparathyroidism

“…Less commonly there is facial bone involvement, and mandibular and maxillary bones are the facial bones that are usually involved [6]. When a tumor of the maxilla has been diagnosed as a giant cell tumor, hyperparathyroidism should be ruled out to exclude the possibility that it is a brown tumor [7].…”

Granulomatous interstitial nephritis associated with silica

“…Secondary HPT is a frequent complication of chronic renal failure, but brown tumour has a rare incidence in those patients. 1 It is composed of fibrous stroma associated with multinucleated giant cells. The commonly affected sites are the long bones, ribs and facial bones, extensive osteolytic destructions are extremely rare.…”

“…Although the mechanism of silica nephropathy was not fully understood, granules formation was supposed to involve autoimmune disorder. 1 After oral steroid therapy (max prednisolone 30 mg/day) for one year, we performed re-biopsy. The macroscopic appearance of the kidney specimen was still dark brown.…”

Misdiagnosed as osteosarcoma: Brown tumour in a haemodialysis patient

“…Brown tumour is usually regarded as a benign skeletal complication of primary and secondary hyperparathyroidism (HPT). Secondary HPT is a frequent complication of chronic renal failure, but brown tumour has a rare incidence in those patients . It is composed of fibrous stroma associated with multinucleated giant cells.…”