title: Giant Cell Lesions Associated with Primary Hyperparathyroidism.
abstract: OBJECTIVE
  To evaluate the prevalence, clinical features, diagnostic laboratory values and treatment outcome of giant cell lesions (brown tumors) associated with primary hyperparathyroidism (PHPT) in oral and maxillofacial region.
  
  
  METHODS
  A 5 year retrospective data was analyzed wherein all histopathologically proven cases of giant cell lesions involving oral and maxillofacial region were evaluated. Out of these cases, those associated with PHPT were tabulated. Correlation was established with other concomitant clinical features and also with the laboratory values of altered serum calcium, phosphate, alkaline phosphate and parathormone. Follow up of these cases after the correction of PHPT was also noted.
  
  
  RESULTS
  Out of 85 cases of histopathologically proven giant cell lesions, five cases were associated with PHPT. There was involvement of maxilla and mandible in one case each. Only frontal bone was involved in two cases. Fifth case had multiple lytic lesions in maxilla and frontal bone. All patients consistently showed very high values of alkaline phosphate and parathormone. Hypercalcemia and hypophosphatemia was noted in four cases. All cases showed regression of the lytic lesion after parathyroidectomy obviating the need for surgical excision of the jaw lesions.
  
  
  CONCLUSIONS
  Giant cell lesions (brown tumors) associated with PHPT in oral and maxillofacial region are rare clinical entities. The prevalence of PHPT associated giant cell lesions is 5.9 %. They are clinically, radiologically and histopathologically similar to any other peripheral or central giant cell tumor. Relevant history may alert the clinician and altered biochemical values may help in correlating the oral and maxillofacial findings with the underlying systemic disease. At times, the brown tumor maybe the only presenting sign leading to the diagnosis of PHPT.
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Rai
authors.affiliation: Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Vidya
authors.initials: V
authors.lastname: Rattan
authors.affiliation: Department of Endocrinology and Metabolism, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012 India.
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Bhadada
keywords: Alkaline phosphatase; Brown tumor; Giant cell lesion; Hypercalcemia; Parathyroid hormone; Primary hyperparathyroidism