1/25. Brown tumour of hyperparathyroidism in the mandible associated with atypical parathyroid adenoma.The brown tumour of hyperparathyroidism is a localized bone tumour and an uncommon manifestation of hyperparathyroidism. A 27-year-old woman presented with a mandibular 8 x 10 cm solid mass diagnosed as central giant cell granuloma. Chemical blood analysis revealed increased serum calcium levels of 12.46 mg/dL and the parathyroid hormone level was 124 pg/dL. The patient underwent surgery with removal of a parathyroid mass. Histologically, this parathyroid tissue was seen to be limited by a fibrous capsule with morphological features consistent with atypical parathyroid adenoma. The mandibular tumour has receded and the patient declined further procedures. This is the first case reported of brown tumour as the primary manifestation of an atypical parathyroid adenoma, a lesion that shares some features with parathyroid carcinoma without the unequivocal properties of malignancy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/25. Highly aggressive brown tumour of the maxilla as first manifestation of primary hyperparathyroidism.A case is presented of a 62-year-old man with a right maxillary swelling for the previous three months. The lesion was expansive and osteolytic, with invasion of the adjacent maxillary sinus, nasal and pterygomaxillary fossae and floor of the orbit. histology revealed the presence of an intrabony giant cell lesion. blood tests demonstrated elevations in calcium (16.2 mg/dl) and parathyroid hormone (PTH) concentrations (841 pg/ml). This suggested the diagnosis of hyperparathyroidism initially manifesting as a brown tumour of the maxilla. Posterior explorations confirmed the existence of an underlying ectopic parathyroid adenoma as the cause of the condition.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/25. Asymptomatic hyperparathyroidism caused by a giant parathyroid adenoma.On routine investigation a 57-year-old woman was found to have primary hyperparathyroidism caused by a giant parathyroid gland. The gland was removed successfully and histological examination proved it to be a parathyroid adenoma.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
4/25. Spontaneous retropharyngeal hematoma of a parathyroid cyst: report of a case.A 41-year-old woman presented with severe and sudden anterior neck swelling, pain, and dysphagia. Computed tomography (CT) scan and ultrasound of the neck showed a giant mass in the retropharyngeal space, displacing the trachea and esophagus anteriorly. Aspiration cytology was done, following which extensive cervical and chest ecchymosis occurred and her symptoms immediately improved. A repeat CT scan demonstrated that the cervical giant mass had vanished, but there was a residual mass in the left paratracheal space. Exploratory surgery of the neck revealed a parathyroid cyst with severe adhesion to the surrounding tissues. We considered that a ruptured parathyroid cyst had induced massive hemorrhage into the cervical tissues and mediastinum, but that the hemorrhage had been absorbed. Extracapsular hemorrhage from a parathyroid adenoma or cyst is rare, especially from a parathyroid cyst. In fact, to our knowledge, this represents only the third case of symptomatic spontaneous bleeding of a parathyroid cyst. Nevertheless, this entity should still be considered in the differential diagnosis of all rapidly progressing retropharyngeal masses.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
5/25. Vertebral localization of a brown tumor: description of a case and review of the literature.The authors report a case of a female aged 45 years submitted to a long period of hemodialysis, affected with brown tumor of the lumbar spine. Brown tumor must be taken into consideration in the differential diagnosis of osteolytic lesions of the skeleton, particularly in young, nephropathic women undergoing hemodialysis. Brown tumor has a more favorable prognosis as compared to other lesions that have similar clinical and radiographic findings, such as metastatic lesions and giant cell tumors. In the case of brown tumor, in addition to treating lesion of the spine, treatment varying depending on neurological findings and biomechanical complications (structural collapse, segmental kyphosis, pathologic fracture, etc.), removal of the parathyroids and correction of the metabolic alterations is indispensable.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/25. Brown tumor of the femur associated with double parathyroid adenomas.Severe parathyroid bone disease is a rare clinical presentation of primary hyperparathyroidism. Double parathyroid adenomas are even more rare cause of primary hyperparathyroidism. The authors present a case of double parathyroid adenomas in a 48-year-old man, who presented with painful left lower limb swelling, which was slowly growing in size in the last 20 years. magnetic resonance imaging revealed a cystic bony lesion and coincidentally, a urinary bladder calculus. biopsy of the mass revealed giant cell lesion. Laboratory investigations showed hypercalcemia and hypophosphatemia with elevated parathyroid hormone level. A computerized tomography scan of the neck delineated an adenoma of the left superior parathyroid gland, which was surgically removed. The left inferior parathyroid was also enlarged and was removed. Histological diagnosis confirmed double parathyroid adenomas. The rarity and the interesting clinical presentation of such association are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/25. Unusual presentation of a giant parathyroid adenoma: report of a case.Parathyroid adenomas account for most cases of primary hyperparathyroidism (1 degrees HPT). Certain symptoms and biochemical abnormalities alert the surgeon to their presence, since these benign tumors are rarely evident on physical examination. Moreover, because they are usually very small, preoperative localization using sestamibi scanning or ultrasonography is required to avoid bilateral neck exploration. Parathyroid adenomas rarely attain huge proportions. We report a case of a parathyroid adenoma measuring 8 x 5 x 3.5 cm and weighing 110 g; to our knowledge the greatest mass reported in the literature. Interestingly, despite its huge size it did not cause many of the hypercalcemic symptoms usually associated with larger adenomas, but rather it manifested with symptoms of local pressure, another unusual property of this atypical tumor.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
8/25. Giant cell tumours of the maxilla and tibia presenting concurrently as an initial manifestation of primary parathyroid adenoma.A 14 years female of Afghan origin reported with maxillofacial and tibia growths causing progressive deformities since nine months, both were giant cell tumours on histopathology. serum calcium was normal, but the parathyroid hormone was exaggerated (678 pg/ml). Ultrasound indicated and Tc-99m Setamibi scan confirmed a left lower parathyroid lesion. A 4cm length mass was identified, removed and proved to be a parathyroid adenoma. Two weeks later a subtotal maxillectomy and six weeks later anterior wedge osteotomy of the tibia were carried out. serum parathyroid hormone level normalized.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/25. Malignant hypercalcemia associated with a parathyroid macrocyst and the early genesis of a giant cell tumor.Parathyroid cysts rarely cause primary hyperparathyroidism. In most cases, the resultant hypercalcemia is mild and detected before any significant skeletal disease develops. We report a patient with severe hypercalcemia, a synchronous brown tumor (osteitis fibrosa cystica) of the maxilla, and a large benign functional parathyroid cyst. The unusual patient presentation and management are described and illustrated. The pertinent literature is reviewed.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/25. Primary hyperparathyroidism: evaluation of different treatments of jaw lesions based on case reports.On the basis of three case reports, different treatment modalities of primary hyperparathyroidism of the jaws are presented. Surgical intervention made as the result of misdiagnosis in the first case caused an unnecessary bone defect and delayed bone regeneration for several months. Two other cases showed spontaneous regeneration of bone after parathyroidectomy. The second case disproved the earlier opinion that regeneration of the bone lesions could last for several years, and that the normal morphology could be restored. Complete resolution of the central giant-cell lesion was found 6 months after removal of the parathyroid adenoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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