Simultaneous Maxillary and Mandibular Brown Tumors in Secondary Hyperparathyroidism: A Case Report

Abstract

Hyperparathyroidism (HPT) is a disease, which results from increased secretion of parathyroid hormone
(PTH). Primary HPT results from autonomous hyperplasia or a tumor in parathyroid and secondary
HPT is usually associated with decreased calcium level due to chronic renal disease. Brown
tumors have been seen occasionally at the terminal stages of HPT. A case of 19-year-old man with
history of end-stage renal disease (ESRD) demonstrating two expansive lesions in jaws is reported
here. PTH and alkaline phosphatase (ALP) were extremely high and consequently, a diagnosis of
secondary HPT was established. Contrary to the typical secondary HPT, the patient was normocalcemic.
Computed tomography scan showed mixed radiolucent-radioopaque pattern of lesions and
ossifications were significant. Surgical excision was carried out and histology revealed presence of
fibro-endothelial connective tissue with broad areas of osteoids and numerous multinucleated giant
cells, as seen in cases of brown tumors.
Keywords: Alkaline phosphatase, brown tumors, hyperparathyroidism