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Dentomaxillofacial Radiology (2007) 36, 360-363
© 2007 British Institute of Radiology
doi: 10.1259/dmfr/19204128

CASE REPORTS

Primary hyperparathyroidism presenting as an exophytic mandibular mass

AD Dinkar1, S Sahai*,1 and M Sharma2

1 Oral Medicine, Diagnosis and Radiology Department, Goa Dental College and Hospital, Bambolim, Goa, India; 2 Radiology Department, Goa Medical College and Hospital, Bambolim, Goa 403 202, India

*Correspondence to: Dr Sharad Sahai, 3rd year MDS, Oral Medicine, Diagnosis and Radiology Department, Goa Dental College and Hospital, Bambolim, Goa 403 202, India; Email: sahai_sharad{at}hotmail.com

Received 6 August 2006; revised 11 October 2006; accepted 3 November 2006

A 36-year-old female patient presented with a massive painless swelling in the left mandible. The patient's medical history was unremarkable. The initial clinical and radiological evaluation indicated an aggressive odontogenic neoplasm or a metastasis from an unknown primary; the suspicion of a systemic metabolic or endocrine disorder lay low on the list of differential diagnoses. Further investigations revealed gross skeletal changes and a hypoechoic right parathyroid mass. The total serum parathyroid hormone levels and ultrasound-guided fine needle aspiration cytology (FNAC) of the mandibular and parathyroid lesions provided the diagnosis of primary hyperparathyroidism presenting as a mandibular brown tumour. This case thus highlights the importance of a thorough diagnostic work-up for all lesions in the maxillofacial region and also serves to add another facet to the myriad of presentations associated with primary hyperparathyroidism.

Keywords: mandible; brown tumour; hyperparathyroidism; radiographs; computed tomography (CT); ultrasound






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