ABSTRACT
Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. Brown tumours are one of the bony complications of hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, an extremely rare case of a 19-year-old male patient with brown tumours in his maxilla and mandible associated with tertiary hyperparathyroidism is presented. A thorough diagnostic work-up was carried out and treatment options for both hyperparathyroidism and brown tumours were discussed. The importance of different radiological evaluation methods and the consultation between the oral and maxillofacial surgeons, general practitioner dentists, endocrinologists and radiologists are emphasised.
Subject(s)
Hyperparathyroidism, Secondary/complications , Mandibular Diseases/diagnostic imaging , Maxillary Diseases/diagnostic imaging , Osteitis Fibrosa Cystica/diagnostic imaging , Osteitis Fibrosa Cystica/etiology , Diagnosis, Differential , Humans , Hyperparathyroidism, Secondary/etiology , Kidney Failure, Chronic/complications , Male , Mandibular Diseases/etiology , Maxillary Diseases/etiology , Parathyroid Glands/diagnostic imaging , Radiography, Panoramic , Radionuclide Imaging , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Tomography, X-Ray Computed , Ultrasonography , Young AdultABSTRACT
The observation that p53 alterations are early events in the tumorigenesis of head and neck cancer and the association with cigarette smoking have prompted us to search for p53 overexpression in the oral mucosa of heavy smokers who have no overt precancerous or cancerous lesions. Formalin-fixed paraffin embedded tissue sections, obtained from oral mucosa of 30 otherwise healthy heavy smokers, were evaluated for tobacco related changes, and immunostained with a mouse monoclonal antibody p53-DO7 for p53 immunoreactivity. Histopathological evaluation revealed hyperplastic changes in twenty eight samples (93%), eight of which also demonstrated dysplastic changes. Positive immunoreaction for p53 was detected in six (20%) of the tissue samples. The study provided significant information about the frequency of hyperplasia, dysplasia, and p53 overexpression in individuals who were heavy smokers. It is suggested, also, that chemoprevention might have some impact in this particular group of individuals.