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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

Intra operative view showing post debridement site using Brosch procedure and preserved inferior alveolar nerve
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Figure 4: Intra operative view showing post debridement site using Brosch procedure and preserved inferior alveolar nerve

Mentions: Considering the histological diagnosis of a giant cell lesion, the patient was subjected for PTH estimation, renal function tests (RFT), and complete blood investigation. The PTH was 635.5 (14.0–72.0) pg/ml, alkaline phosphatase 421 (33–96) U/l, total calcium 7.8 (8.7–10.2) mg/dl and phosphorous was 4.10 (2.5–4.3) mg/dl. Complete skeletal radiographs ruled out the presence of any bony lesions. Serum Vitamin D was not measured due to resource limitations. The patient was treated conservatively with surgical debridement alone using modified Brosch's procedure, sacrificing the third molar and preserving the inferior alveolar nerve [Figure 4], followed by maxillo-mandibular fixation for 6 weeks. On endocrinologist's reference, the patient was diagnosed to be suffering from hypocalcemia/secondary hyperparathyroidism, the cause being nutritional or vitamin D deficiency. She was advised Tab. calcium carbonate, chewable, thrice daily, with cholecalciferol sachet 60 000 U once a week, after a stat dose of Inj. Arachitol 6 lakh unit along with calcium rich diet, and suggestion to increase sunshine exposure through outdoor activities.


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)

Intra operative view showing post debridement site using Brosch procedure and preserved inferior alveolar nerve
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Intra operative view showing post debridement site using Brosch procedure and preserved inferior alveolar nerve
Mentions: Considering the histological diagnosis of a giant cell lesion, the patient was subjected for PTH estimation, renal function tests (RFT), and complete blood investigation. The PTH was 635.5 (14.0–72.0) pg/ml, alkaline phosphatase 421 (33–96) U/l, total calcium 7.8 (8.7–10.2) mg/dl and phosphorous was 4.10 (2.5–4.3) mg/dl. Complete skeletal radiographs ruled out the presence of any bony lesions. Serum Vitamin D was not measured due to resource limitations. The patient was treated conservatively with surgical debridement alone using modified Brosch's procedure, sacrificing the third molar and preserving the inferior alveolar nerve [Figure 4], followed by maxillo-mandibular fixation for 6 weeks. On endocrinologist's reference, the patient was diagnosed to be suffering from hypocalcemia/secondary hyperparathyroidism, the cause being nutritional or vitamin D deficiency. She was advised Tab. calcium carbonate, chewable, thrice daily, with cholecalciferol sachet 60 000 U once a week, after a stat dose of Inj. Arachitol 6 lakh unit along with calcium rich diet, and suggestion to increase sunshine exposure through outdoor activities.

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