title: Highly aggressive brown tumor in the jaw associated with tertiary hyperparathyroidism.
abstract: The purpose of this paper is to describe the case of a 12-year-old patient with end-stage chronic renal failure. The patient presented with an osteolytic lesion in the mandible with expansion of the buccal, lingual, and occlusal cortical bone, as well as dislocation of the teeth in the area. The calcium, creatinine, and parathormone (PTH) contents of the blood were elevated. A histopathological examination of the jaw lesion revealed the presence of a brown tumor lesion, which is associated with hyperparathyroidism (HPT). An adenoma was found in the upper left parathyroid, a finding compatible with the diagnosis of tertiary HPT. In spite of the continuous ambulatory peritoneal dialysis instituted, the osteolytic lesion kept on growing. A conservative treatment employing an association of intralesional corticosteroid and salmon calcitonin (inhaled) was carried out. After 14 months of therapy, a reduction in size and complete calcification of the lesion were achieved. Aesthetic osteoplasty of the jaw was then performed.
authors.affiliation: Bucomaxillofacial Surgery, São Lucas Hospital--Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
authors.forename: Lécio Pitombeira
authors.initials: LP
authors.lastname: Pinto
authors.forename: Karen
authors.initials: K
authors.lastname: Cherubinim
authors.forename: Fernanda Gonçalves
authors.initials: FG
authors.lastname: Salum
authors.forename: Liliane Soares
authors.initials: LS
authors.lastname: Yurgel
authors.forename: Maria Antonia Zancanaro
authors.initials: MA
authors.lastname: de Figueiredo
mesh_terms: D000236:Adenoma / Q000150:complications; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002116:Calcitonin / Q000627:therapeutic use; D002648:Child; D006101:Granuloma, Giant Cell / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008336:Mandibular Diseases / Q000188:drug therapy / Q000209:etiology*; D010002:Osteitis Fibrosa Cystica / Q000188:drug therapy / Q000209:etiology*; D010014:Osteolysis / Q000209:etiology; D010282:Parathyroid Neoplasms / Q000150:complications; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D002116:Calcitonin; D014222:Triamcinolone Acetonide