An extreme case of Brown tumor affecting both jaws

Abstract

Brown tumors are focal bone lesions caused by an increased osteoclastic activity and fibroblastic proliferation within hyperparathyroidism. They are named after their typical brown hemorrhagic stroma with its also typical giant cell formations. In this case report we describe a patient with a history of renal stone operated four times and osteolytic bone lesions affecting both jaws in all four segments. Patients face was asymmetric due to the extend of the tumor on the left maxilla. Biopsy of the left mandible revealed giant cell tumor and presumed differential diagnosis included Brown tumor. PTH level was 1565 pg/ml and calcium level was 20 mg/dl. After a detailed examination in endocrine clinics, patient was undergone parathyroidectomy operation. Even in the third month after surgery, bony lesions were regressed and facial asymmetry was unremarkable. Patients with bony lesions should not be operated for giant cell tumor, hyperparathyroidism must be considered as differential diagnosis.