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

Journal of Medical Case Reports 07/2009; 3(1):7495. DOI: 10.4076/1752-1947-3-7495
Source: PubMed


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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Available from: Chariton Papadakis
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    • "Brown tumors represent a localized manifestation of osteitis fibrosa cystica and the most common affected sites are mandible, maxilla, clavicle, ribs, and pelvic bones. They have been reported to occur in 4.5% of patients with primary hyperparathyroidism, usually secondary to a parathyroid adenoma or hyperplasia [6]. Histologically, brown tumors are composed of multiple multinucleated giant cells arranged diffusely or in groups mixed with mononuclear stromal cells with oval to spindle morphology and hemosiderin deposition [7]. "
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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.
    Full-text · Article · Sep 2014 · Case Reports in Endocrinology
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    • "It is interesting that the histological appearance of the BT is identical to that of the central giant cell granuloma. Therefore, patient with giant cell lesions should be screened for serum calcium, PTH, and alkaline phosphatase [4]. This papers aims to highlight a rare case of BT of posterior maxilla in a 17-year-old male patient as a consequence of vitamin D deficiency. "
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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.
    Full-text · Article · Aug 2014
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    • "Brown tumor is rarely involved in the maxilla. The reported prevalence of brown tumors is 0.1%, with a male to female ratio of 1:3 (Proimos et al., 2009). Symptoms can occur at any age; however, the disease is more common in persons older than 50 years Primary hyperparathyroidism in 80% of the cases is due to a parathyroid adenoma; in over 15% of the cases it is due to a glandular hyperplasia, and extremely rare due to a parathyroid adenocarcinoma (Thompson et al., 1982). "
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    ABSTRACT: Brown tumors are uncommon focal giant-cell lesions that arise as a direct result of the effect of parathyroid hormone on bone tissue in some patients that have hyperparathyroidism. Primary hyperparathyroidism could be caused by ectopic mediastinal parathyroid adenomas. The occurrence of lesions is explainable on embryologic basis. We present a 55-year-old Saudi woman with a rare case of brown tumor of the maxilla due to ectopic mediastinal parathyroid adenoma.
    Full-text · Article · Apr 2014 · Saudi Dental Journal
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