Brown tumor of the facial bones: case report and literature review.
Brown tumor, an uncommon focal giant-cell lesion, arises as a direct result of the effect of parathyroid hormone on bone tissue inpatients with hyperparathyroidism. The initial treatment involves the correction of hyperparathyroidism, which usually leads to tumor regression. We report a case of brown tumor of the right nasal fossa in a 71-year-old woman. The tumor had caused nasal obstruction and epistaxis. Laboratory evaluation revealed that the patient had primary hyperparathyroidism. Anatomicopathologic investigation revealed the presence of a giant-cell tumor We performed a partial parathyroidectomy, but the tumor in the right nasal fossa failed to regress. One year later we performed surgical resection of the lesion. The patient recovered uneventfully, and she remained asymptomatic and recurrence-free at the 1-year follow-up. Facial lesions with histologic features of a giant-cell tumor should be evaluated from a systemic standpoint. Hyperparathyroidism should always be investigated by laboratory tests because most affected patients are asymptomatic. Surgical resection of a brown tumor should be considered if the mass does not regress after correction of the inciting hyperparathyroidism or if the patient is highly symptomatic.
Lessa
Marcus M
MM
Department of Otorhinolaryngology, University Hospital, University of São Paulo Medical School, SP-Brazil.
Sakae
Flavio A
FA
Tsuji
Robinson K
RK
Filho
Bernardo C Araújo
BC
Voegels
Richard L
RL
Butugan
Ossamu
O
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018212:Giant Cell Tumor of Bone / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009295:Nasal Bone; D016105:Parathyroidectomy / Q000379:methods; D018570:Risk Assessment; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome