Highly aggressive brown tumor in the jaw associated with tertiary hyperparathyroidism.
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.
Pinto
Lécio Pitombeira
LP
Bucomaxillofacial Surgery, São Lucas Hospital--Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Cherubinim
Karen
K
Salum
Fernanda Gonçalves
FG
Yurgel
Liliane Soares
LS
de Figueiredo
Maria Antonia Zancanaro
MA
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
D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D002116:Calcitonin; D014222:Triamcinolone Acetonide