title: Brown tumor of secondary hyperparathyroidism: surgical approach and clinical outcome.
abstract: BACKGROUND
  Secondary hyperparathyroidism is a frequent complication of chronic renal failure. The brown tumor is an unusual presentation of fibrous osteitis that represents a serious complication of renal osteodystrophy, affecting predominantly the hands, feet, skull, and facial bones.
  
  
  METHODS
  The aim of this paper is to describe the case of a 53-year-old female patient, with renal failure who has been on dialysis for 6 years and developed severe secondary hyperparathyroidism and brown tumor of the maxilla and mandible, confirmed by incisional biopsy. Parathyroidectomy was indicated as a result of rapid growth of the tumor and the maintenance of laboratory findings. Despite the normalization of serum parathyroid hormone and alkaline phosphatase, tumor regression was slow and patient's important functional and esthetic deficits persisted. Excision of the mandible tumor was conservative. Osteoplasty was recommended because during a 5-year follow-up there was regression of the lesion, decreased pain, bleeding, and tooth mobility.
authors.affiliation: Federal University of Bahia, Salvador, Brazil. isaacvq@yahoo.com.br.
authors.forename: Isaac Vieira
authors.initials: IV
authors.lastname: Queiroz
authors.affiliation: Federal University of Bahia, Salvador, Brazil.
authors.forename: Samara Pereira
authors.initials: SP
authors.lastname: Queiroz
authors.affiliation: Federal University of Pernambuco, Recife, Brazil.
authors.forename: Rui
authors.initials: R
authors.lastname: Medeiros
authors.affiliation: Federal University of Bahia, Salvador, Brazil.
authors.forename: Rodolfo Bonfim
authors.initials: RB
authors.lastname: Ribeiro
authors.affiliation: Federal University of Bahia, Salvador, Brazil.
authors.forename: Iêda Margarida
authors.initials: IM
authors.lastname: Crusoé-Rebello
authors.affiliation: Federal University of Pernambuco, Recife, Brazil.
authors.forename: Jair Carneiro
authors.initials: JC
authors.lastname: Leão
mesh_terms: D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000601:surgery*; D005146:Facial Asymmetry / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010002:Osteitis Fibrosa Cystica / Q000000981:diagnostic imaging / Q000601:surgery*; D016105:Parathyroidectomy; D014057:Tomography, X-Ray Computed
keywords: Bone diseases; Osteitis fibrosa cystica; Parathyroidectomy; Renal osteodystrophy; Secondary hyperparathyroidism