Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity

Verma, Pradhuman; Verma, Kanika; Verma, Dinesh; Patwardhan, Nitin

doi:10.4103/0973-029x.140779

Cited by 23 publications

(16 citation statements)

References 8 publications

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“…It may appear in any bone, but is often found in the bones of the face and jaw, especially in cases of longstanding disease 1 . In this case, the lesion was located in the mandibular symphysis region, a fact consistent with the literature 1,7,11,12 .…”

Section: Discussionsupporting

confidence: 90%

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Brown tumor as a result of secondary hyperparathyroidism in chronic renal disease

Mascarenhas¹,

Marchionni²,

Rebouças³

et al. 2016

J Oral Diag

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Introduction: Brown tumor is a focal lesion of giant cells that develops in association with hyperparathyroidism. Objective: To report a case of brown tumor that occurred in the mandibular symphysis region, associated with secondary hyperparathyroidism. Case report: A 45-year-old male patient with chronic renal failure exhibited increased volume with comorbid local paresthesia in the mandibular symphysis region. Radiographs showed a unilocular radiolucent area with partially defined edges in the anterior mandible region. The histopathological findings revealed connective tissue, rich in oval, notched cells and giant cells with hemosiderin pigments. Laboratory tests showed increased serum levels of parathyroid hormone. An attempt to control the hormone levels with medication while the patient awaited a kidney transplant was unsuccessful. Therefore, as a transplant was not imminent and injury continued to develop, the lesion was surgically excised. Three years later, the lesions recurred in the paranasal region. Following partial removal of the lesions, the patient is now under follow-up care. Conclusion: Correct diagnosis and effective treatment of brown tumor requires correlation of biochemical data with the patient's clinical, imaging, and histological profile.

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Section: Discussionsupporting

confidence: 90%

“…Radiographically and histopathologically, the latter resembles other bone injuries that occur on the face. The differential diagnosis is determined from the PTH, calcium, and alkaline phosphatase levels in the blood 11 .…”

Section: Discussionmentioning

confidence: 99%

Brown tumor as a result of secondary hyperparathyroidism in chronic renal disease

Mascarenhas¹,

Marchionni²,

Rebouças³

et al. 2016

J Oral Diag

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“…In contrast to our patient, bony hypercorticalization wasn't reported in any of these cases. 4,[13][14][15][16][17][18][19][20][21] Because hypercorticalization is not a typical oral manifestation of hyperparathyroidism, extensive technical investigations to rule out other etiologies were performed. The most common reported radiologic feature of hyperparathyroidism is a loss of the lamina dura in 7%-46% of cases.…”

Section: Discussionmentioning

confidence: 99%

Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: a case report

Aerden

Grisar

Nys

et al. 2018

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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We present the case of a 32-year-old male patient complaining of recurrent mandibular pain for 3.5 years. Panoramic radiography indicated increased cortical density of the mandibular lower border. Scintigraphy and single-photon emission computed tomography revealed metabolic hyperactivity in that region without pathologic lymph nodes. A bone biopsy specimen of the mandibular lower border did not have inflammation or cytologic atypia. Endocrinologic investigation confirmed secondary hyperparathyroidism as a result of hypovitaminosis D. Several weeks after starting therapy with oral vitamin D supplements, the symptoms completely disappeared. Increased cortical density is a rare manifestation of secondary hyperparathyroidism, which normally causes the lamina dura to vanish and produces a ground-glass appearance as a result of blurring of the trabecular bone pattern. Because focal hyperostosis can have multiple benign or malignant causes, radiologic examination of the jaw bones is indispensable for evaluating orofacial pain. Increased cortical density may be caused by metabolic diseases, requiring further investigations, including biopsy and blood analysis.

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“…Brown tumors represent the final stage of hyperparathiroidism [21]. Radiographically, this lesions appear as well-demarcated monolocular or multilocular osteolythic areas which can cause sometimes root resorbtion or changes in the trabecular pattern of the bone [8,21,22]. Brown tumors can occur as solitary or multiple lessions in any bone and usually do not require specific treatment.…”

Section: Table 1 the Etiology Of Renal Diseasementioning

confidence: 99%

Oral and Maxillofacial Manifestations of Mineral and Bone Disorders Associated with Chronic Renal Failure

Doscas¹,

Bălan²,

Ciofu³

et al. 2017

Rev. Chim.

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Chronic kidney disease (CKD) is a multifactorial syndrome and a global health concern. As renal function declines, there is a progressive deterioration of mineral homeostasis. Starting from stage 3 of CKD oral manifestations of mineral disorders can occasionally appear and become more frequent and evident in stage 5. We retrospectively analysed 43 patients diagnosed with end stage renal failure undergoing dialysis, hospitalized in our clinic for different oral and maxillofacial pathologies. The mean dialysis period was 5.43 years. Radiographic alterations afecting the jaws were found in all patients. The most common feature was partial or total loss of lamina dura, followed by alterations of the bony trabeculae. 9 patients presented brown tumors which are considered the final stage of secondary hyperparathyroidism associated with renal failure.

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Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity

Cited by 23 publications

References 8 publications

Brown tumor as a result of secondary hyperparathyroidism in chronic renal disease

Brown tumor as a result of secondary hyperparathyroidism in chronic renal disease

Secondary hyperparathyroidism causing increased jaw bone density and mandibular pain: a case report

Oral and Maxillofacial Manifestations of Mineral and Bone Disorders Associated with Chronic Renal Failure

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