BACKGROUND Primary hyperparathyroidism is characterized by hypercalcemia and elevated or inappropriately normal serum levels of parathyroid hormone. Brown tumor of bone is a rare non-neoplastic lesion resulted from abnormal bone metabolism in hyperparathyroidism. However, nowadays, skeletal disease caused by primary hyperparathyroidism is uncommon. We report a case of brown tumor in the mandible as the initial exhibition of primary hyperparathyroidism associated with an atypical parathyroid adenoma. CASE PRESENTATION The patient was a 49-year-old female, she had a pain mass on the right mandible a year ago and was treated with root canal therapy and marginal resection. After seven months, the mass recurred and enlarged. Enhanced CT scan, laboratory examination, Ultrasonography, 99mTc-MIBI SPECT-CT scintiscan and pathological examination were used to confirm the diagnosis of brown tumor. The patient's symptom improved after parathyroidectomy. CONCLUSIONS 99mTc-MIBI SPECT/CT scintigraphy is a highly sensitive examination of the localization diagnosis of hyperparathyroidism. Brown tumors should be considered in the differential diagnosis of osteolytic lesions to avoid unnecessary and harmful interventions.

中文翻译：

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原发性甲状旁腺功能亢进症的下颌骨呈棕色肿瘤：一例病例报告。

背景技术原发性甲状旁腺功能亢进症的特征在于高钙血症和甲状旁腺激素的正常血清水平升高或升高。骨骼的棕色肿瘤是甲状旁腺功能亢进症中异常的骨骼代谢所致的罕见非肿瘤性病变。然而，如今，由原发性甲状旁腺功能亢进引起的骨骼疾病并不常见。我们报告下颌骨出现棕色肿瘤，这是与非典型甲状旁腺腺瘤相关的原发性甲状旁腺功能亢进的初步表现。病例介绍该患者是一名49岁的女性，一年前右下颌骨疼痛，并接受了根管治疗和边缘切除术。七个月后，肿块复发并扩大。增强型CT扫描，实验室检查，超声检查，99mTc-MIBI SPECT-CT闪烁扫描和病理学检查证实了棕色肿瘤的诊断。甲状旁腺切除术后患者症状改善。结论99mTc-MIBI SPECT / CT闪烁显像是对甲状旁腺功能亢进症定位诊断的高度敏感检查。在溶骨性病变的鉴别诊断中应考虑棕色肿瘤，以避免不必要和有害的干预措施。