Aggressive Brown tumors of the maxilla and mandible post-parathyroidectomy in chronic renal failure: A case report and literature review

Abstract

Brown tumor is a condition associated with hyperparathyroidism that can affect various bones, including the facial skeleton. These tumors are typically well-defined radiolucent lesions but can grow large and cause disfigurement. It is crucial to diagnose brown tumors especially in the jaws early, as those involving the maxillo-mandibular region can exhibit highly aggressive behavior. Also, following parathyroidectomy or normalization of parathyroid hormone (PTH) levels, patients should be closely monitored for the presence of brown tumors. It is advisable to consider the removal of brown tumors even after the correction of underlying hyperparathyroidism. Regular follow-up examinations are necessary to assess the progression or regression of these tumors. In this study, we present a case of a 42-year-old female with renal failure and a history of parathyroidectomy presented with brown tumors in both jaws. The tumors showed aggressive characteristics such as cortical expansion and significant patient discomfort. After clinical and radiological evaluation, the patient underwent surgical excision, which involved total mandibulectomy and maxillectomy. The excised tissue was then subjected to histopathological analysis; the results confirmed brown tumor in both jaws.

Keywords

• Brown tumor
• Osteitis fibrosa cystica
• Recklinghausen disease of bone
• Bone diseases
• Hyperparathyroidism