Late resolution of brown tumor two years after parathyroidectomy: Case report with eight years follow-up

Mauricio Neves Gomes; Ariadne Padilha de Andrade; Wagner Gomes-Silva; Priscila Abranches de Britto Pinheiro; Rodrigo Nascimento Lopes; Bruno Felipe Gaia; Marco Aurélio Petroni Montezuma; Luiz Guilherme Cernaglia Aureliano de Lima; Thais Bianca Brandão

doi:10.5327/2525-5711.415

Autores

Mauricio Neves Gomes Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil. https://orcid.org/0009-0003-1347-0626
Ariadne Padilha de Andrade Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil. https://orcid.org/0009-0008-5790-4728
Wagner Gomes-Silva Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil.
Priscila Abranches de Britto Pinheiro University of São Paulo, Medical School Hospital – São Paulo (SP), Brazil. https://orcid.org/0000-0003-2807-8072
Rodrigo Nascimento Lopes Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil. https://orcid.org/0000-0002-5513-2794
Bruno Felipe Gaia Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil. https://orcid.org/0009-0009-4481-8721
Marco Aurélio Petroni Montezuma Instituto do Câncer do Estado de São Paulo, Dental Oncology Service – São Paulo (SP), Brazil.
Luiz Guilherme Cernaglia Aureliano de Lima Instituto do Câncer do Estado de São Paulo, Department of Pathology – São Paulo (SP), Brazil. https://orcid.org/0000-0002-3718-358X
Thais Bianca Brandão Hospital Sírio-Libanês, Department of Oral Medicine – São Paulo (SP), Brazil. https://orcid.org/0000-0001-9128-3138

DOI:

https://doi.org/10.5327/2525-5711.415%20

Palavras-chave:

Hyperparathyroidism, Parathyroid neoplasms, Bone resorption, Bone remodeling, Parathyroid hormone

Resumo

Brown tumors are a type of non-neoplastic lesion characterized by the presence of osteolytic bone lesions in patients with hyperparathyroidism. These lesions are more commonly seen in females, older patients, and can also occur in other bones such as the femur, clavicle, ribs, and pelvis. This case report aims to highlight a rare case of a male patient who was diagnosed with a brown tumor two years after undergoing parathyroidectomy for parathyroid carcinoma. PTH, calcium, and phosphate levels were within normal ranges. Histopathological analysis revealed features indistinguishable from a giant cell–rich lesion; however, normal PTH, calcium, and phosphate levels excluded active hyperparathyroidism, supporting the diagnosis of a residual brown tumor. The lesion was considered an old brown tumor caused by hyperparathyroidism secondary to parathyroid carcinoma. Clinical and radiological follow-ups were conducted over an 8-year period, demonstrating bone neoformation with no signs of recurrence. Prosthetic rehabilitation was completed. Comprehensive evaluation of brown tumors is essential to ensure accurate diagnosis and appropriate treatment. Parathyroid carcinoma can also be a cause of hyperparathyroidism and can be related to a poor outcome if not treated adequately. These bone lesions should be a sign for a judicious systemic evaluation to be performed to exclude malignancies and also discover if there is an underlying cause. Late detection of a jaw brown tumor after parathyroidectomy with normal biochemical parameters is exceedingly rare, particularly in male patients.

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