Brown tumor of the maxillary sinus in a patient with primary hyperparathyroidism: a case report.

Journal of Medical Case Reports 07/2009; 3:7495. DOI: 10.4076/1752-1947-3-7495
Source: PubMed

ABSTRACT Brown tumors are rare focal giant-cell lesions that arise as a direct result of the effect of parathyroid hormone on bone tissue in some patients with hyperparathyroidism. Brown tumors can affect the mandible, maxilla, clavicle, ribs, and pelvic bones. Therefore, diagnosis requires a systemic investigation for lesion differentiation.
We present a 42-year-old Greek woman, with a rare case of brown tumor of the maxillary sinus due to primary hyperparathyroidism. Primary hyperparathyroidism is caused by a solitary adenoma in 80% of cases and by glandular hyperplasia in 20%.
Differential diagnosis is important for the right treatment choice. It should exclude other giant cell lesions that affect the maxillae.

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    ABSTRACT: Brown tumour [BT] is an uncommon, non neoplastic complication of Hyperparathyroidism [HPT]. Skeletal changes are the main consequences of this endocrine condition. HPT manifest in three categories. Primary HPT is due to hyperfunction of one or more parathyroid gland, causing an increase of parathyroid hormone secretion resulting in hypercalcemia. Secondary HPT occurs due to chronic renal failure, decreased vitamin D production or with hypocalcemia. Tertiary HPT occurs when the parathyroid activity turns autonomous and excessive, leading to hypercalcemia. BT occurs frequently in the mandible than the maxilla. They are more common in women aged over 50y and majority of BT are asymptomatic. Radiographically, it appears as well defined radioluceny. The gross specimen usually shows a brown or reddish-brown colour. We report a relatively rare combination of maxillary posterior BT as a clinical manifestation of secondary HPT due to vitamin D deficiency with polydactyly, syndactyly and cardiac anomalies.
    Journal of clinical and diagnostic research : JCDR. 08/2014; 8(8):ZD31-3.
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    ABSTRACT: The authors present a case study of a 40-year-old man with advanced, previously undiag-nosed primary hyperparathyroidism (PHPT), which first manifestation directing to correct diagnosis was sellar-parasellar brown tumor. Further studies disclosed PHPT. The patient presented many of the classic signs of the dis-ease, including renal stones, duodenal ulcer, muscle weakness and bone pains, but suspi-cion of PHPT was made on the base of a post-operative histological examination of the sell-ar-parasellar tumor. Laboratory investigations showed hypercalcaemia, hypophosphataemia, elevated levels of parathyroid hormone and alkaline phosphatase. A skeletal survey showed generalized decreased density of bones and multiple brown tumors. The problems of diag-nosis and localization of parathyroid glands have been discussed. The literature has been reviewed and the importance of early diagnosis and treatment has been stressed.
    Endocrinology Studies. 01/2012; 2(1).
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    ABSTRACT: Brown tumors are osteolytic bone lesions that occur as a result of persistent hyperparathyroidism. They usually appear late in the natural history of the disease and are currently very rare due to an earlier diagnosis of primary hyperparathyroidism. We present the case of a 53-year-old female with a 2-month history of bitemporal hemianopsia and diplopia. A computed tomography showed an osteolytic bone lesion that involved the sphenoid corpus and clivus. A biopsy was made and the histopathology result was consistent with a brown tumor. The aforementioned location is very infrequent to such tumors, and therefore represented a diagnostic challenge. However, in this case, its association to primary hyperparathyroidism was the clue for the diagnosis. The association of a brown tumor secondary to a parathyroid carcinoma has been seldom reported. This case represents, to our knowledge, one of the few brown tumors described in such location and the first secondary to a parathyroid carcinoma.
    Case reports in endocrinology. 01/2014; 2014:837204.

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