Brown tumor of the mandible as an initial presentation of hyperparathyroidism

Abstract

The paper presents a brown tumor case related to secondary hyperparathyroidism in an end stage kidney disease patient undergoing dialysis treatment. The interesting feature of the case is that the primary clinical presentation of the condition was a mild swelling in the attached gingiva of a mandibular molar tooth. Medical practitioners should be alert to the fact that some pathological conditions may have an initial presentation in the oral cavity. Thus, a thorough and careful examination of the oral mucosa with the accompanying dental radiographs of patients, should be noted and studied in all cases, where available.

Perspective Chapter: Parathyroid Glands in Dentistry

“…In our case, the brown tumor of the mandible was the first sign of the condition (hyperparathyroidism) due to inbalance of osteoblastic and osteoclastic activities, formed by increased parathyroid hormone levels and calcium phosphorous serum level regulation. Upon re-examining the patient, there was no recurrence of the lesion or presence of other similar lesions [9]. Our case had the unusual primary detection of the condition in the mandible.…”

“…In the later panoramic radiograph of the patient, the lesion had progressed to a well-defined lucency adjacent to the tooth's roots extending to the surrounding bone. The lesion was removed regionally, and the systemic management revolved primarily in reducing circulating endocrine hormone (parathyroid hormone) [9].…”