Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism


Brown tumor or localized form of osteitis fibrosa cystic is a focal lesion complicating hyperpara-thyroidism. It’s rarely revelatory of the clinical feature and corresponds to a mass with partly cystic and partly solid areas. A 65-year-old man, followed up for hypertension, complained of a progressive swelling in the left paranasal part of the face lasting for 3 months. Physical examination revealed a left paranasal swelling of 4 cm diameter, with a healthy looking skin. CT facial bones found a round formation of 2 cm involving the left maxilla. He received tumor resection by vestibular pathway. Histological examination showed many giant cells. We then discussed the brown tumor diagnosis. The PTH dosage was high: 645 pg/mL (normal: 15 - 68 pg/mL). The serum calcium was in the superior normal limit (100 mg/dL). Cervical ultrasound revealed a bottom left parathyroid nodule. A lower left parathyroidectomy was performed. Histological results confirmed parathyroid adenoma. Monitoring was marked by a marked decrease of the PTH serum level then a return to normal values, a normocalcemia and no recurrence of the maxillary tumor with Recoil of 14 months. Brown tumor of the maxilla is rare and should be considered even in absence of hypercalcemia.

Share and Cite:

Mahfoudhi, M. , Khamassi, K. , Battikh, A. , Lahiani, R. , Sami, T. and Salah, M. (2015) Brown Tumor of the Maxilla Revealing Primary Hyperparathyroidism. International Journal of Clinical Medicine, 6, 252-256. doi: 10.4236/ijcm.2015.64031.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] [1] Herowitz, M., Wishard, J.M., Need, A.G., Morris, H.A. and Nordin, B.E. (1994) Primary Hyperparathyroidism. Clinics in Geriatric Medicine, 10, 757-772.
[2] Parisien, M., Silverberg, S.J., Shane, E., Dempster, D.W. and Bilezikian, J.P. (1990) Bone Diseases in Primary Hyperparathyroidism. Endocrinology Metabolism Clinics of North America, 19, 18-34.
[3] Mundy, G.R., Cove, D.H. and Fisken, R. (1980) Primary Hyperparathyroidism: Changes in the Pattern of Clinical Presentation. Lancet, 1, 1317-1320.
[4] Owens, B.B. (2009) A Review of Primary Hyperparathyroidism. Journal of Infusion Nursing, 32, 87-92.
[5] Rosenberg, E.H. and Guralnick, W.C. (1962) Hyperparathyroidism. A Review of 220 Proved Cases with Special Emphasis on Findings in the Jaws. Oral Surgery, 157, 82-93.
[6] Guney, E., Yigitbasi, O.G., Bayram, F., Ozer, V. and Canoz, O. (2001) Brown Tumor of the Maxilla Associated with Primary Hyperparathyroidism. Auris Nasus Larynx, 28, 369-372.
[7] Morano, S., Cipriani, R., Gabriele, A., Medici, F. and Pantellini, F. (2000) Recurrent Brown Tumors as Initial Manifestation of Primary Hyperparathyroidism. An Unusual Presentation. Minerva Medica, 91, 117-122.
[8] El Abdi, B., Berrkia, I., Mohssine, A., El Hassani, M.R., El Quessar, A., Chakir, N., et al. (2006) Tumor of the Maxilla Presenting as Primary Hyperparathyroidism. Journal of Radiology, 87, 1705-1707.
[9] Thorwarth, M., Rupprecht, S., Schlegel, A., Neureiter, D. and Kessler, P. (2004) Central Giant Cell Granuloma and Osteitis Fibrosa Cystica of Hyperparathyroidism. A Challenge in Differential Diagnosis of Patients with Osteolytic Jawbone Lesions and a History of Cancer. Mund-, Kieferund Gesichtschirurgie, 8, 316-321.
[10] Lehnerdt, G., Metz, K.A., Krüger, C. and Dost, P. (2003) A Bone-Destroying Tumor of the Maxilla. Reparative Giant Cell Granuloma or Brown Tumor? HNO, 51, 239-244.
[11] Stolovitzky, J.P., Waldron, C.A. and McConnel, F.M. (1994) Giant Cell Lesions of the Maxilla and Paranasal Sinuses. Head Neck, 16, 143-148.
[12] Fancello, A., Caradonna, L. and Tullio, A. (1998) Giant-Cell Reparative Granuloma (GCRG). A Review of the Literature, the Present State of Knowledge and Therapeutic Suggestions. Minerva Stomatologica, 47, 399-407.
[13] Khochtali, H., Ach, K., Jlidi, R., Bouhaouala, H., Ben Gaid Hassine, N., Essakly, M.K., et al. (1991) Bilateral Brown Tumor of the Jaw. A Propos of a Case. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, 92, 116-119.
[14] Reséndiz-Colosia, J.A., Rodríguez-Cuevas, S.A., Flores-Díaz, R., Juan, M.H., Gallegos-Hernández, J.F., Barroso-Bravo, S., et al. (2008) Evolution of Maxillofacial Brown Tumors after Parathyroidectomy in Primary Hyperparathyroidism. Head Neck, 30, 1497-1504.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.