Brown tumors of the oral cavity: presentation of 4 new cases and a systematic literature review

Lajolo, Carlo; Patini, Romeo; Limongelli, Luisa; Favia, Gianfranco; Tempesta, Angela; Contaldo, María; Corso, Eugenio De; Giuliani, Michele

doi:10.1016/j.oooo.2020.02.002

Cited by 23 publications

(35 citation statements)

References 24 publications

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“…Brown tumors of hyperparathyroidism are lesions that result from abnormal bone metabolism in primary, secondary, or tertiary hyperparathyroidism 4,5 . The lesions might affect single or multiple bones, such as the ribs, clavicles, pelvic girdle, and occasionally the jaws, particularly the posterior regions of the mandible 6 . The incidence of brown tumors of hyperparathyroidism range from 1.5% to 3%, being more common in primary hyperparathyroidism.…”

Section: Introductionmentioning

confidence: 99%

KRAS mutations in brown tumor of the jaws in hyperparathyroidism

Guimarães

Gomes

Pereira

et al. 2020

J Oral Pathology Medicine

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Background Brown tumors are giant cell‐rich lesions that result from abnormal bone metabolism in hyperparathyroidism, one of the most common endocrine disorders worldwide. Brown tumors occasionally affect the jaws and, despite well‐known clinical and microscopic features, their molecular pathogenesis remains unclear. We investigated the presence of pathogenic activating mutations in TRPV4, FGFR1, and KRAS in a cohort of brown tumors since these have recently been reported in giant‐cell lesions of the jaws and non‐ossifying fibromas of the bones (FGFR1 and KRAS), which are histologic mimics of brown tumors. Methods We target sequenced 13 brown tumors of the jaws associated with primary or secondary hyperparathyroidism. As mutations in these genes are known to activate the MAPK/ERK signaling pathway, we also assessed the immunostaining of the phosphorylated form of ERK1/2 (pERK1/2) in these lesions. Results KRAS pathogenic mutations were detected in seven cases (p.G12V n = 4, p.G12D n = 1, p.G13D n = 1, p.A146T n = 1). KRAS variants of unknown significance (VUS), p.A134T and p.E37K, were also detected. All samples showed wild‐type sequences for FGFR1 and TRPV4 genes. The activation of the MAPK/ERK signaling pathway was demonstrated by pERK1/2 immunohistochemical positivity of the brown tumors´ mononuclear cells. Conclusion Mutations in KRAS and activation of the MAPK/ERK signaling pathway were detected in brown tumors of hyperparathyroidism of the jaws, expanding the spectrum of giant cell lesions whose molecular pathogenesis involve RAS signaling.

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Section: Introductionmentioning

confidence: 99%

KRAS mutations in brown tumor of the jaws in hyperparathyroidism

Guimarães

Gomes

Pereira

et al. 2020

J Oral Pathology Medicine

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“…Considering the possibility that PGCGs could represent the first clinical sign of an undiagnosed PHPT and the fact that the screening of PHPT is a non-invasive and cheap exam, already used in some countries, in case of histological diagnosis of a giant cell lesion, both central [26] and peripheral, especially in patients with synchronous or history of methacronous giant cell lesions, should be mandatory parathyroidal screening.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Giant Cell Granuloma of the Jaws as First Sign of Primary Hyperparathyroidism: A Case Series

Limongelli

Tempesta

Lauritano

et al. 2020

JCM

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Peripheral giant cell granulomas (PGCG) associated with hyperparathyroidism (HPT) are rare clinical entities. The aim of this study is to report on 21 PGCGs of the oral cavity as the first clinical sign of unknown primary HPT (PHPT) referred to the Complex Operating Unit of Odontostomatology of Aldo Moro University of Bari from 2009 to 2019. Surgical treatment consisted in conservative enucleation of the lesion, if possible, with contextual bone rim osteoplasty with piezosurgical tools and following histological examination. After histological diagnosis of PGCG, PHPT screening was performed dosing parathyroid hormone and serum calcium. In all the patients haematological investigation demonstrated elevated values of parathyroid hormone and serum calcium ruling out an unknown PHPT. Specifically, after endocrinological evaluation, patients showed PHPT related to: parathyroid adenoma (13), parathyroid hyperplasia (two, one of which occurred in a intra-thyroidal parathyroid), and parathyroid carcinoma (1) and were scheduled for surgical treatment. Considering that PGCGs could represent the first clinical sign of an undiagnosed PHPT and the screening of PHPT is a non-invasive and cheap exam, in case of histological diagnosis of a giant cell lesion, both central and peripheral, especially in patients with synchronous or history of methacronous giant cell lesions, parathyroidal screening should be mandatory.

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“…Jenis perawatan tersebut dipilih dengan mempertimbangkan berbagai aspek seperti usia pasien, perluasan lesi, lokasi lesi, dan keparahan kondisi hiperparatiroid pada masingmasing pasien. 1,3,8,13,14,15,16,17 Tujuan dari penulisan telaah pustaka ini adalah untuk membahas pentingnya diagnosis dan pemilihan perawatan yang tepat pada kondisi brown tumor mandibula oleh dokter gigi sehingga dapat meningkatkan keberhasilan perawatan dan mencegah kerusakan yang lebih parah akibat lesi brown tumor.…”

Section: Pendahuluanunclassified

“…21 Berbagai laporan kasus menyebutkan rata-rata usia pasien hiperparatiroidisme dengan lesi brown tumor adalah 41 tahun (rentang usia antara 19 hingga 68 tahun) dengan 68% kasus terjadi pada wanita. 3,10,13,16 Diagnosis brown tumor ditegakkan melalui berbagai macam pemeriksaan yaitu pemeriksaan klinis, pemeriksaan histopatologi, pemeriksaan laboratorium, dan pemeriksaan radiologi. 10 Lesi brown tumor pada rongga mulut umumnya berkembang pada mandibula sebagai manifestasi tunggal selain itu lesi ini juga dapat berkembang pada maksila sehingga terbentuk manifestasi multipel.…”

Section: Brown Tumorunclassified

Perawatan Brown Tumor pada Mandibula Pasien dengan Hiperparatiroid (HPT) Tersier

Purnamasari

Waskitoaji

Riyadi

et al. 2021

IDJ

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Hiperparatiroidisme (HPT) merupakan kondisi yang disebabkan oleh meningkatnya produksi dan sekresi hormon paratiroid (PTH). Tipe HPT diklasifikasikan menjadi tiga dan HPT tersier merupakan yang paling jarang terjadi. Kerusakan tulang merupakan komplikasi yang paling sering terjadi pada HPT tersier yaitu sebesar 25% dari total pasien HPT dan brown tumor merupakan salah satu bagian dari komplikasi tersebut. Lesi ini sering terjadi pada tulang kortikal, termasuk mandibula. Pemeriksaan klinis, radiografis, histopatologi, dan biokimia serum dilakukan dalam upaya diagnosis brown tumor. Perawatan brown tumor dilakukan melalui dua pendekatan yaitu bedah dan non-bedah. Tujuan dari penulisan telaah pustaka ini adalah menjelaskan pentingnya diagnosis dan perawatan yang tepat pada kondisi brown tumor pada mandibula oleh dokter gigi sehingga kerusakan yang lebih parah dapat dicegah. Pemilihan jenis perawatan lesi brown tumor yang tepat didapatkan melalui pemeriksaan yang komprehensif sehingga didapatkan hasil perawatan yang memuaskan. Telaah pustaka ini berjenis telaah pustaka naratif. Pencarian pustaka dilakukan melalui sumber elektronik seperti PubMed, Google Scholar, dan Clinical Key dengan kriteria inklusi dan eksklusi tertentu. Kesimpulan dari telaah pustaka ini adalah pemeriksaan klinis, laboratoris, histologis, serta radiografis yang baik menghasilkan diagnosis yang tepat sehingga dapat mencegah keparahan dan mengurangi kerusakan akibat lesi tersebut.

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Brown tumors of the oral cavity: presentation of 4 new cases and a systematic literature review

Cited by 23 publications

References 24 publications

KRAS mutations in brown tumor of the jaws in hyperparathyroidism

KRAS mutations in brown tumor of the jaws in hyperparathyroidism

Peripheral Giant Cell Granuloma of the Jaws as First Sign of Primary Hyperparathyroidism: A Case Series

Perawatan Brown Tumor pada Mandibula Pasien dengan Hiperparatiroid (HPT) Tersier

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