Brown Tumour Of Hyperparathyroidism, A Benign Latency In The Jaws (A Review of Literature)

Brown Tumour of Hyperparathyroidism, a benign latency in the jaws: A Review of Literature

Authors

  • Lalit Sagara
  • Mitsu Meshram
  • Jigar Dhuvad
  • Sonal Anchlia
  • Siddharth Vyas
  • Harsh Shah

DOI:

https://doi.org/10.70284/njirm.v7i4.1123

Keywords:

Brown tumour, giant cell lesion, mandible, primary hyperparathyroidism

Abstract

Background: To inculcate awareness about the importance of thorough screening of the patients presenting with giant cell lesions in the jaw bones for clinical, biochemical and radiological features of hyperparathyroidism. Material and Methods: The history, physical examination, laboratory values, imaging and pathologic findings are described in a 32-year-old woman, presenting with brown tumour lesion in mandible, due to primary hyperparathyroidism. A systematic review of published literature from PubMed is added, which highlights the importance of a thorough diagnostic workup and selection of appropriate treatment modality. Results: In the case presented, after Parathyroid adenoma excision, within thirty minutes, the serum values of Parathormone and Calcium returned to normalcy and spontaneous regression of the brown tumour was noted. Also, the review of literature emphasized the need for systemic investigations of suspected giant cell jaw lesions and established that parathyroidectomy can be considered the primary treatment modality for brown tumours of the jaw due to hyperparathyroidism. Conclusion: Radiolucent lesions of the jaws showing giant cells on histopathology should raise suspicion of hyperparathyroidism. This case emphasizes the importance of a detailed systemic investigation for all lesions in the maxillofacial region. [Lalit S NJIRM 2016; 7(4):158-164]

References

1. S. Gangidi, R. Dyer, and D. Cunliffe, “Not all radiolucencies of the jaw require enucleation: a case of brown tumour,” Bri J of Oral and Maxillofac Surg, 2012;50(3):e33–e35.
2. Duran C, Ersoy C, Bolca N, et al. Brown tumours of the maxillary sinus and patella in a patient with primary
hyperparathyroidism. The Endocrinologist 2005; 15:351–4.
3. Neville BW, Damm DD, Allen CM, et al: Oral and Maxillofacial Pathology. Philadelphia, WB Saunders, 2002; 544–547.
4. Smith BR, Fowler CB, Svane TJ, et al: Primary hyperparathyroidism presenting as a ‘‘peripheral’’ giant cell granuloma. J Oral Maxillofac Surg1988; 46:65.
5. Marx RE, Stern D: Oral and Maxillofacial Pathology, A Rationale for Diagnosis and Treatment. Chicago, Quintessence Publishing, 2003;783–879.
6. Goshen O, Aviel-Ronen S, Dori S, et al: Brown tumour of hyperparathyroidism in the mandible associated with atypical parathyroid adenoma. J Laryngol Otol 2000; 114:302.
7. Whyte S, Cannon M.: In search of stones, bones, abdominal groans and psychic moans: putting the pieces together- a case of parathyroid adenoma. Perspectives. 2009; 33(2):5-7.
8. Martinez-Gravida EM, Bagan JV, Milian-Masanet MA, et al: Highly aggressive brown tumour of the maxilla as first manifestation of primary hyperparathyroidism.
Int J OralMaxillo fac Surg 2000; 29:447.
9. Mohammed Qaisi, Matthew Loeb, Lindsay Montague, and Ron Caloss: Case Report Mandibular Brown Tumour of Secondary Hyperparathyroidism Requiring Extensive Resection: A Forgotten Entity in the Developed World? Case Reports in Medicine 2015; 10 pages,2015
10. Keyser JS, Postma GN. Brown tumour of the mandible. Am J Otolaryngol 1996; 17(6): 407-10.
11. Bringhrust FR, Demay MB, Kronenber HM. Hormones and disorders of mineral metabolism. In: Wilson J, Foster D, Kronenberg H, Larsen P, Eds. Williams textbook of endocrinology. 9th ed. Philadelphia: WB Saunders 1998; 1155-1209.
12. J. A. Reséndiz -Colosia, S. A. Rodrıguez-Cuevas, R. Flores- Dıaz et al., “Evolution of maxillofacial brown tumours afterparathyroidectomy in primary hyperparathyroidism,” Head and Neck, 2008;30(11):1497–1504.
13. K. Triantafillidou, L. Zouloumis, G. Karakinaris, E. Kalimeras, and F. Iordanidis, “Brown tumours of the jaws associated with primary or secondary hyperparathyroidism. A clinical study and review of the literature,” The American Journal of Otolaryngology—Head and Neck Medicine and Surgery, 2006; 27(4): 281–286.
14. A. H. Emin,Y. S¨uo˘glu,D.Demir, and M. C.Karatay, “Normocalcemic hyperparathyroidism presented with mandibular brown tumour: report of a case,” Auris Nasus Larynx, 2004;31(3):299–304.
15. M. M. Suarez-Cunqueiro, R. Schoen, et al, “Brown tumour of the mandible as first manifestation of atypical parathyroid adenoma,” Journal of Oral and Maxillofacial Surgery, 2004; 62(8):1024–1028.
16. J. S. M. Daniels, “Primary hyperparathyroidism presenting as a palatal brown tumour,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 2004; 98(4):409–413.
17. M. D. Walsh Jr., K. Chan, S. Travers, and R. C. McIntyre Jr., “Destructive maxillomandibular brown tumour in severe hyperparathyroidism,” Journal of the American College of Surgeons, 2005; 201(2):315.
18. V. Grulois, I. Buysschaert, J. Schoenaers, F. Debruyne, P. Delaere, and V. Vander Poorten, “Brown tumour: presenting symptom of primary hyperparathyroidism,” B-ENT, 2005; 1(4):191–195.
19. Fernández-Sanromán J, Antón-Badiola JM, Costas-López A. Brown tumor of the mandible as first manifestation of primary hyperparathyroidism: diagnosis and treatment. Med Oral Patol Oral Cir Bucal 2005;10:169-72.
20. P. S. Pahlavan and M. C. Severin, “Parathyroid carcinoma: a rare case with
mandibular brown tumour,” Wiener Klinische Wochenschrift, 2006; 118(5-6):175–179.
21. A. Oh, P. Mojica, M. Sullivan et al., “Malignant hypercalcemia associated with a parathyroid macrocyst and the early genesis of a giant cell tumour,” American Journal of Otolaryngology, 2006; 27(1):54–57.
22. S. Desigan, R. Syed, G. S. Conway, T. R. Kurzawinski, and J. B. Bomanji, “Giant cervical parathyroid adenoma mimicking a sternocleidomastoid mass and presenting as a brown tumour of the mandible,” Clinical Nuclear Medicine, 2007;32(4):306– 308.
23. A. D. Dinkar, S. Sahai, and M. Sharma, “Primary hyperparathyroidism
Presenting as an exophytic mandibular mass,” Dentomaxillofacial Radiology, 2007; 36(6):360–363.
24. F. Jebasingh, J. J. Jacob, A. Shah, T. V. Paul, and M. S. Seshadri, “Bilateral maxillary brown tumours as the first presentation of primary hyperparathyroidism,” Oral and Maxillofacial Surgery, 2008;12(2):97–100.
25. Y. Sutbeyaz, O. Yoruk, H. Bilen, and N. Gursan, “Primary hyperparathyroidism presenting as a palatal and mandibular brown tumour,” The Journal of Craniofacial Surgery, 2009; 20(6):2101–2104.
26. E. Proimos, T. S. Chimona, D. Tamiolakis, M. G. Tzanakakis, and C. E. Papadakis, “Brown tumour of the maxillary sinus in a patient with primary hyperparathyroidism: a case report,” Journal of Medical Case Reports, 2009; 3:74-95.
27. A. Benhammou, M. Meziane, N. Dib et al., “Maxilla-mandibular brown tumours as a first sign of parathyroid adenoma,” Annalesd’Oto-Laryngologieet de ChirurgieCervico-Faciale, 2009; 126(4):216–220.
28. P. V. Angadi, K. Rekha, and S. R. Shetty, “‘An exophytic mandibular brown tumour’: an unusual presentation ofprimary hyperparathyroidism,” Oral and Maxillofacial Surgery, 2010; 14(1):67–69.
29. N. Soundarya, P. Sharada, N. Prakash, and G. L. Pradeep, “Bilateral maxillary brown tumours in a patient with primary hyperparathyroidism: report of a rare entity and review of literature,” Journal of Oral andMaxillofacial Pathology, 2011; 15(1):56–59.
30. M. Alhusban and Z. H. Baqain, “Mandibular brown tumour as the first manifestation of primary hyperparathyroidism: a case report,” Saudi Dental Journal, 2011; 23(2): 107–109.
31. L.A. Guldfred, S. Daugaard, and C. von Buchwald, “Brown tumour mimicking maxillary sinus mucocele as the first manifestation of primary hyperparathyroidism,” AurisNasus Larynx, 2012; 39(4):418–421.
32. E. Bahrami, T. Alireza, H. Ebrahim, and S. Mohammadreza, “Maxillary and orbital brown tumour of primary hyperparathyroidism,” American Journal of Case Reports, 2012; 13:183–186.
33. H.-K. Sia, M.-C. Hsieh, L.-H. Yang, and S.-T. Tu, “Maxillary brown tumour as initial presentation of parathyroid adenoma: a case report,” Kaohsiung Journal of Medical Sciences, 2012; 28(7):400–403.
34. F. Mantar, S. Gunduz, and U. R. Gunduz, “A reference finding rarely seen in primary hyperparathyroidism: brown tumour,” Case Reports in Medicine, 2012; 2012, Article ID 432676: 4 pages.
35. Praveen, A.H., Thriveni, R. Maxillary and mandibular hyperparathyroidism. Natl. J. Maxillofac. Surg. 2012; 3 (1), 51–54.
36. Doshi S, Vadi A, Mahajan A, Nagpal T: Primary hyperparathyroidism with rare presentation as multiple brown tumours. ClinPract. 2012; 2(2): e48
37. S. Chowdhury, A. Aggarwal, N. Mittal, and A. Shah, “Brown tumour of hyperparathyroidism involving craniomaxillofacial region: a rare case report and literature review,” Minerva Stomatologica, 2013; 62(9):343–348.
38. W. Pawlak, A. Bohdanowicz-Pawlak, M. Bolanowski, J. Szymczak, G. Bednarek-Tupikowska, and K. Łuczak, “Primary hyperparathyroidism presenting as a giant cell tumour of the jaws,” Neuroendocrinology Letters, 2013;34(2):107–110.
39. S. Rafizadeh, V. M. Duarte, C. Lai, and D. K. Chhetri, “Tumour of maxilla in a patient with hypercalcemia,” JAMA Otolaryngology—Head and Neck Surgery, 2013; 139(7):741– 742.
40. J. J. Wilson, H. C. Schwartz, and G. M. Tehrany, “Brown tumour of the posterior maxilla as initial manifestation of primary hyperparathyroidism: case report,” Journal of Oral and Maxillofacial Surgery, 2013; 71(5):886–890.
41. V.DiFede, O. DiFede, V. Rodolico, G. Campisi, and A. Cordova: “Mandibular brown tumour as the first manifestation of primary hyperparathyroidism: a case report,” Annali di Stomatologia, 2013; 4(supl 2):14–15.
42. Faiza A. Qari: Brown tumour in a patient with ectopic mediastinal parathyroid adenoma: A case report. The Saudi Dental Journal 2014; 26:74–77.
43. H. Mori, Y. Okada, T. Arao, S. Shimaziri, and Y. Tanaka, “A case of multiple brown tumours with primary hyperparathyroidism,” Journal of Bone and Mineral Metabolism, 2013; 31(1):123–127.
44. A. Guerrouani, A. Rzin, and K. El Khatib, “Hyperparathyroidism-jaw tumour syndrome detected by aggressive generalized osteitisfibrosacystica,” Clinical Cases in Mineral and Bone Metabolism, 2013; 10(1):65–67.
45. A. R. Pati, Mubeen, K. R. Vijayalakshmi, and C. Singh, “Diagnosis and clinico-radiological presentation in an aggressive maxillary brown tumour,” Journal of Clinical and Diagnostic Research, 2014; 8(5):ZD13–ZD15.
46. Kunte A.R., Dube V.S., Balwantkar S.S., Kulkarni K.K.: Parathyroid adenoma in a young female presenting as recurrent acute pancreatitis with a brown tumourof the mandible—A case study. International Journal of Surgery Case Reports, 2015; 7:10-15.
47. AkshayDinakarShetty, J Namitha, Leena James. Brown Tumour of Mandible in Association with Primary Hyperparathyroidism: A Case Report. Journal of International Oral Health 2015; 7(2):50-52.
48. Huang R, Zhuang R, Liu Y, Li T, Huang J: Unusual presentation of primary hyperparathyroidism: report of three cases. BMC Med Imaging. 2015; 15:23.
49. C. T. S. Leal, P. G. S. Lacativa, E.M. S. Gomes et al., “Surgical approach and clinical outcome of a deforming brown tumour at the maxilla in a patient with secondary hyperparathyroidism due to chronic renal failure,” Arquivos Brasileiros de Endocrinologia Metabologia, 2006;50(5):963–967.
50. Selvi F, Cakarer S, Tanakol R, Guler SD, Keskin C. Brown tumour of the maxilla and mandible: A rare complication of tertiary hyperparathyroidism. Dentomaxillofac Radiol 2009; 38(1):53-8.
51. Guney E, Yigitbasi OG, Bayram F, et al: Brown tumour of the maxilla associated with primary hyperparathyroidism. AurisNasus Larynx 2001; 28:369.
52. Rosenberg EH, Guralinick WC: Hyperparathyroidism: A review of 220 proved cases, with special emphasis on findings in the jaws. Oral Surg1962; 15(suppl 2):83.
53. Kar DK, Gupta SK, Agarwal A, et al: Brown tumour of the palate and mandible in association with primary hyperparathyroidism. J Oral MaxillofacSurg2001; 59:1352-4.
54. Pellegrino SV: Primary hyperparathyroidism exacerbated by pregnancy. J Oral Surg 1977; 35:915.
55. Ferretti C, Muthray E: Management of central giant cell granuloma of mandible using intralesional corticosteroids: Case report and review of literature. J Oral MaxillofacSurg 2011;69:2824-9.
56. Yamazaki H, Ota Y, Aoki T, et al. Brown tumour of the maxilla and mandible: progressive mandibular brown tumour after removal of parathyroid adenoma. J Oral MaxillofacSurg 2003; 61(6):719 - 22.
57. Guney E, Yigitbasi OG, Bayram F, et al. Brown tumour of the maxilla associated with primary hyperparathyroidism. AurisNasus Larynx 2001; 28(4):369 – 72.
58. Rajeevan NS, Soumithran CS. Intralesional corticosteroid injection for central giant cell granuloma. A case report. Int J Oral MaxillofacSurg 1998; 27(4):303 - 4.
59. Yamazaki H, Ota Y, Aoki T, Karakida K. Brown tumour of the maxilla and mandible: progressive mandibular brown tumour after removal of parathyroid adenoma. J Oral Maxillofac Surg. 2003; 6:719–22.

Downloads

Published

2018-01-23

How to Cite

Sagara, L., Meshram, M., Dhuvad, J., Anchlia, S., Vyas, S., & Shah, H. (2018). Brown Tumour Of Hyperparathyroidism, A Benign Latency In The Jaws (A Review of Literature): Brown Tumour of Hyperparathyroidism, a benign latency in the jaws: A Review of Literature. National Journal of Integrated Research in Medicine, 7(4), 158–164. https://doi.org/10.70284/njirm.v7i4.1123

Issue

Section

Review Article