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Brown tumor in mandible as a first sign of vitamin D deficiency: A rare case report and review.

Arunkumar KV, Kumar S, Deepa D - Indian J Endocrinol Metab (2012)

Bottom Line: They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1.Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies.Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India.

ABSTRACT
Central giant cell granulomas (CGCGs) are uncommon but the most aggressive benign intraosseous tumors of jaws, with an unpredictable outcome. They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1. The classical "brown tumor" is commonly seen in the long bones, pelvis, and ribs. Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies. CGCGs are traditionally treated by both surgical and intralesional injection, with a variable recurrence rate. Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

No MeSH data available.


Related in: MedlinePlus

Pre op orthopantomogram showing radiolucency at right angle and ramus of mandible with upward displacement of third molar bud
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Figure 2: Pre op orthopantomogram showing radiolucency at right angle and ramus of mandible with upward displacement of third molar bud

Mentions: A 12-year-old female patient reported with the chief complaint of swelling in the right mandibular angle region since 8 months [Figure 1]. The swelling was slowly growing, bony hard in consistency, and not associated with any symptoms, non-tender, and not mobile. There were no neurosensory deficits or cervical lymphadenopathy evident. Mouth opening was normal with full complement of teeth present except third molars. Diffuse obliteration of right mandibular buccal vestibule, retromolar trigone, and expansion of lingual cortex distal to mandibular right second molar was evident. None of the mandibular right quadrant teeth were tender or mobile. All mandibular teeth were vital. Radiograph revealed tooth bud of third molar, unilocular radiolucency extending from apical and distal of mandibular right second molar to ramus, with sclerotic border at the body region anteriorly and scalloped at the ramus, expanded, leaving thin cortices toward the lower and posterior border of mandible, the third molar apparently pushed upward when compared with the left mandibular third molar, and no evidence of root resorption [Figure 2]. Fine needle aspiration cytology (FNAC) was done with positive aspiration of little frothy appearing blood. Meanwhile, an open curettage biopsy was performed and sent for histopathologic evaluation. The histopathology reported it as CGCG with sections showing fibrocellular connective tissue stroma with numerous plump fibroblasts and multinucleated giant cells, few osteoblasts, and numerous blood vessels [Figure 3].


Brown tumor in mandible as a first sign of vitamin D deficiency: A rare case report and review.

Arunkumar KV, Kumar S, Deepa D - Indian J Endocrinol Metab (2012)

Pre op orthopantomogram showing radiolucency at right angle and ramus of mandible with upward displacement of third molar bud
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3313758&req=5

Figure 2: Pre op orthopantomogram showing radiolucency at right angle and ramus of mandible with upward displacement of third molar bud
Mentions: A 12-year-old female patient reported with the chief complaint of swelling in the right mandibular angle region since 8 months [Figure 1]. The swelling was slowly growing, bony hard in consistency, and not associated with any symptoms, non-tender, and not mobile. There were no neurosensory deficits or cervical lymphadenopathy evident. Mouth opening was normal with full complement of teeth present except third molars. Diffuse obliteration of right mandibular buccal vestibule, retromolar trigone, and expansion of lingual cortex distal to mandibular right second molar was evident. None of the mandibular right quadrant teeth were tender or mobile. All mandibular teeth were vital. Radiograph revealed tooth bud of third molar, unilocular radiolucency extending from apical and distal of mandibular right second molar to ramus, with sclerotic border at the body region anteriorly and scalloped at the ramus, expanded, leaving thin cortices toward the lower and posterior border of mandible, the third molar apparently pushed upward when compared with the left mandibular third molar, and no evidence of root resorption [Figure 2]. Fine needle aspiration cytology (FNAC) was done with positive aspiration of little frothy appearing blood. Meanwhile, an open curettage biopsy was performed and sent for histopathologic evaluation. The histopathology reported it as CGCG with sections showing fibrocellular connective tissue stroma with numerous plump fibroblasts and multinucleated giant cells, few osteoblasts, and numerous blood vessels [Figure 3].

Bottom Line: They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1.Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies.Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India.

ABSTRACT
Central giant cell granulomas (CGCGs) are uncommon but the most aggressive benign intraosseous tumors of jaws, with an unpredictable outcome. They account for less than 7% of all benign jaw lesions, with a female to male ratio of about 2:1. The classical "brown tumor" is commonly seen in the long bones, pelvis, and ribs. Facial bone involvement is rare and usually appears as solitary or multilocular soap bubble like radiolucencies. CGCGs are traditionally treated by both surgical and intralesional injection, with a variable recurrence rate. Here, we report a 12-year-old female patient with mandibular brown tumor as a first sign of secondary hyperthyroidism induced due to vitamin D deficiency and hypocalcemia.

No MeSH data available.


Related in: MedlinePlus