Endocrine Abstracts

Introduction: Brown tumors are osteolytic lesions rarely revealing hyperparathyroidism. They result from abnormalities of bone metabolism. They usually occur in the terminal stage of hyperparathyroidism. We report the case of a patient with hyperparathyroidism revealed by a brown tumor.

Case: A 39-year-old female patient with no notable medical history who presented for 1 year a mandibular swelling progressively increasing in size after a dental extraction without other associated signs. A phosphocalcic assessment was requested, coming back in favor of a primary hyperparathyroidism: high level of calcemia at 132 mg/l, a low phosphoremia at 17 mg/l and an elevated parathormonemia 9 times above the normal. A biopsy of the mass was performed, which anatomopathological examination was in favor of a reparative giant cell granuloma, hence the diagnosis of brown tumor. Cervical ultrasound revealed a 3–4 cm parathyroid adenoma and scintigraphy confirmed the parathyroid origin. The patient underwent parathyroidectomy and the histological study was in favor of an atypical parathyroid adenoma. The evolution was marked by a normalization of the phosphocalcic balance.

Discussion and conclusion: Brown tumors are rarely revealing bone manifestations of primary PTH.Their discovery requires exploration of the parathyroid glands, which are most often the site of an adenoma. Excision of the parathyroid adenoma remains the reference treatment for this condition.