Primary hyperparathyroidism presenting as an exophytic mandibular mass

A 36-year-old female patient presented with a massive painless swelling in the left mandible. The patient's medical history was unremarkable. The initial clinical and radiological evaluation indicated an aggressive odontogenic neoplasm or a metastasis from an unknown primary; the suspicion of a...

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Bibliographic Details
Published in:Dento-maxillo-facial radiology 2007-09, Vol.36 (6), p.360-363
Main Authors: Dinkar, A D, Sahai, S, Sharma, M
Format: Article
Language:English
Subjects:
Adenoma - diagnosis
Adult
Biopsy, Fine-Needle
Dentistry
Diagnosis, Differential
Female
Granuloma, Giant Cell - diagnosis
Humans
Hyperparathyroidism, Primary - diagnosis
Mandibular Diseases - diagnosis
Osteitis Fibrosa Cystica - diagnosis
Parathyroid Hormone - blood
Parathyroid Neoplasms - diagnosis
Ultrasonography, Interventional
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Summary:A 36-year-old female patient presented with a massive painless swelling in the left mandible. The patient's medical history was unremarkable. The initial clinical and radiological evaluation indicated an aggressive odontogenic neoplasm or a metastasis from an unknown primary; the suspicion of a systemic metabolic or endocrine disorder lay low on the list of differential diagnoses. Further investigations revealed gross skeletal changes and a hypoechoic right parathyroid mass. The total serum parathyroid hormone levels and ultrasound-guided fine needle aspiration cytology (FNAC) of the mandibular and parathyroid lesions provided the diagnosis of primary hyperparathyroidism presenting as a mandibular brown tumour. This case thus highlights the importance of a thorough diagnostic work-up for all lesions in the maxillofacial region and also serves to add another facet to the myriad of presentations associated with primary hyperparathyroidism.
ISSN:0250-832X
1476-542X
DOI:10.1259/dmfr/19204128