Brown jaw tumors: Today's unusual presentation of primary hyperparathyroidism

S. Corbetta, D. Rossi, O. D'Orto, L. Vicentini, P. Beck-Peccoz, Anna Spada

Research output: Contribution to journalArticle

Abstract

Primary hyperparathyroidism (pHPT) has changed its clinical features in the last decade becoming a mild biochemical disease, in which the classical fibrous cystic osteitis is a rare complication. The more frequent bone involvement in primary hyperparathyroidism is observed at the distal 1/3 of the radius, where the cortical bone is primarily represented. However, lumbar and femoral osteopenia or osteoporosis prevalently affect hyperparathyroid post-menopausal women. We report two, otherwise healthy, young male patients, who presented a painful jaw swelling. In both patients standard radiographic imaging revealed a low-density well-defined lesion, which caused jaw bone destruction. High levels of serum calcium (14.1-16.6 mg/dl, n.v. 8.1-10.4) and PTH (1172-1928 pg/ml, n.v. 10-65) indicated the presence of pHPT associated with hypertension, asymptomatic renal involvement and osteoporosis with normal serum 25-hydroxyvitamin D levels in both patients. A single huge parathyroid adenoma was successfully removed and within 2 months jaw lesions were almost completely re-mineralized without any other therapeutic intervention in both patients. In conclusion, although brown jaw tumors are a rare complication of the hyperparathyroidism, they should be considered and identified in young patients with severe pHPT. Moreover, such a complication seems to be independent from vitamin D deficiency, suggesting the involvement of other pathogenetic factors.

Original languageEnglish
Pages (from-to)675-678
Number of pages4
JournalJournal of Endocrinological Investigation
Volume26
Issue number7
Publication statusPublished - Jul 2003

Keywords

  • Brown jaw tumour
  • Hyperparathyroidism
  • Osteoporosis
  • Parathyroid adenoma
  • Severe hypercalcemia

ASJC Scopus subject areas

  • Endocrinology

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    Corbetta, S., Rossi, D., D'Orto, O., Vicentini, L., Beck-Peccoz, P., & Spada, A. (2003). Brown jaw tumors: Today's unusual presentation of primary hyperparathyroidism. Journal of Endocrinological Investigation, 26(7), 675-678.