Queiroz Isaac Vieira, Queiroz Samara Pereira, Medeiros Rui, Ribeiro Rodolfo Bonfim, Crusoé-Rebello Iêda Margarida, Leão Jair Carneiro
Federal University of Bahia, Salvador, Brazil.
Federal University of Pernambuco, Recife, Brazil.
Oral Maxillofac Surg. 2016 Dec;20(4):435-439. doi: 10.1007/s10006-016-0575-0. Epub 2016 Sep 17.
Secondary hyperparathyroidism is a frequent complication of chronic renal failure. The brown tumor is an unusual presentation of fibrous osteitis that represents a serious complication of renal osteodystrophy, affecting predominantly the hands, feet, skull, and facial bones.
The aim of this paper is to describe the case of a 53-year-old female patient, with renal failure who has been on dialysis for 6 years and developed severe secondary hyperparathyroidism and brown tumor of the maxilla and mandible, confirmed by incisional biopsy. Parathyroidectomy was indicated as a result of rapid growth of the tumor and the maintenance of laboratory findings. Despite the normalization of serum parathyroid hormone and alkaline phosphatase, tumor regression was slow and patient's important functional and esthetic deficits persisted. Excision of the mandible tumor was conservative. Osteoplasty was recommended because during a 5-year follow-up there was regression of the lesion, decreased pain, bleeding, and tooth mobility.
继发性甲状旁腺功能亢进是慢性肾衰竭常见的并发症。棕色瘤是纤维性骨炎的一种罕见表现，是肾性骨营养不良的严重并发症，主要累及手、足、颅骨和面部骨骼。
本文旨在描述一名53岁女性患者的病例，该患者患有肾衰竭，已接受透析6年，并发严重的继发性甲状旁腺功能亢进以及上颌骨和下颌骨棕色瘤，经切开活检确诊。由于肿瘤快速生长及实验室检查结果持续异常，遂行甲状旁腺切除术。尽管血清甲状旁腺激素和碱性磷酸酶恢复正常，但肿瘤消退缓慢，患者仍存在严重的功能和美观缺陷。下颌骨肿瘤切除较为保守。建议进行骨成形术，因为在5年的随访中病变出现消退，疼痛、出血和牙齿松动减轻。
