Background: Brown tumours are expansile osteolytic lesions of bone, occurring in Hyperparathyroidism. Brown tumours occur most commonly
in ribs, clavicle, long bones and pelvis and are uncommon in other facial bones except mandible. Other facial bones are rarely affected. Brown
tumors are due to the direct effect of the parathyroid hormone. Brown tumors occur more with primary hyperparathyroidism than secondary.
However, they are reported more in secondary hyperparathyroidism. In primary hyperparathyroidism, a parathyroid adenoma is a cause in 81%
while other causes include hyperplasia in 15% and parathyroid carcinoma only in 4%. We present a case report of maxillary Brown tumor due to
parathyroid carcinoma in an elderly male patient.
Case Report: A 67-year-old male presented with right maxillary swelling increasing in size for the last few months associated with ipsilateral nasal
block and right eye epiphora. The contrast CT scan of paranasal sinuses and neck revealed a large expansile right maxillary tumor aggressively
eroding maxillary wall with extension into the orbital oor, ethmoid, sphenoid sinuses, nasal cavity, and oral cavity with the erosion of hard palate
and soft tissue extension to subcutaneous Plane. A three cm sized soft tissue density lesion was also noted posterior to the right thyroid lobe in CT
sections of the neck.
Blood prole was normal except extremely high serum parathormone and calcium as well as mildly elevated serum creatinine (S. PTH 3437
pg./ml. S. Ca. 19 mg%. S. Creatinine 1.77mg%.) Ultrasonography of the abdomen also revealed calcication in the renal medulla.
Right lower parathyroidectomy was done with the frozen section as well as the Intraoperative Rapid PTH assay. The PTH level was reduced by 90
percent of the original value. The nal histopathology was suggestive of parathyroid carcinoma.
Summary: The patient was under regular surveillance, as the maxillary tumor was under remittance after the resection of parathyroid carcinoma.
Parathyroid carcinoma is a very rare tumor and involvement of maxillary bone due to primary hyperparathyroidism due to parathyroid carcinoma is
also uncommon.
Pathologic Fracture of the Femur in Brown Tumor Induced in Parathyroid Carcinoma: A Case Report
