ECE2014 Poster Presentations Calcium and Vitamin D metabolism (68 abstracts)
Primary hyperparathyroidism presented with peripheral brown tumor in the oral cavity: a case report
Gulsah Elbuken 1 , Bora Ozan 2 , Onur Ozturk 3 , Bahadir Yazicioglu 3 , Zulay Kazak 4 , Recep Aktimur 5 , Ilsen Semiha Kececi 6 , Sema Kolcu-Bulbul 7 & Mehmet Derya Demirag 8
1Department of Endocrinology and Metabolism, Samsun Training and Research Hospital, Samsun, Turkey; 2Department of Oral and Maxillofacial Surgery, Samsun Oral Medicine Hospital, Samsun, Turkey; 3Department of Family Medicine, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey; 4Department of Pathology, Samsun Training and Research Hospital, Samsun, Turkey; 5Department of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey; 6Department of Radiology, Samsun Training and Research Hospital, Samsun, Turkey; 7Department of Nuclear Medicine, Samsun Training and Research Hospital, Samsun, Turkey; 8Chief of Internal Medicine Department, Samsun Training and Research Hospital, Samsun, Turkey.
Brown tumor is a non-neoplastic lesion which resulting from abnormal bone metabolism caused by hyperparathyroidism. We report a rare case of peripheral brown tumor related with primary hyperparathyroidism which simulating a peripheral giant cell granuloma of the jaws.
Introduction: PHPT occurs in a setting of excessive parathyroid hormone (PTH) secretion which resulting in hypercalcemia.
Case report: A 50-year-old man was admitted to Samsun Oral Medicine Hospital for evaluation of an oral cavitiy lesion. In physical intraoral examination, there was a sessile swelling on the anterior region of the maxilla, in 27×16×13 mm diameter. The lesion was surgically removed and histopathological analysis was reported a giant cell tumor.
Blood analysis demonstrated PTH level of 355 pg/ml (normal range: 15–65). Serum calcium and alkaline phosphatase levels were also upper than normal limits, whereas phosphorus level was lesser. The patient was referred to our outpatient clinic of Endocrinology and Metabolism of Samsun Training and Research Hospital. Neck ultrasonography revealed a solitary lesion on the right parathyroid region. Tecnesium-99 m MIBI imaging detected a mass nearby inferior right thyroid gland, compatible with a parathyroid adenoma.
Discussion: Bone involvement of PHPT is usually seen in the ribs, clavicles, pelvic girdle, hand and the mandible. The jaw bones are commonly affected by brown tumors in PHPT. Peripheral manifestation of brown tumor on the oral cavity is rare, the clinical appearance simulates peripheral giant cell granuloma. The brown tumor is a kind of giant cell lesion and appears as multiple expansive osteolytic lesions of the bone. The clinical diagnosis is made based the associacion with PHPT.
Conclusion: We reported a rare case of peripheral brown tumor associated with PHPT simulating a peripheral giant cell lesion.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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