Evolution of maxillofacial brown tumors after parathyroidectomy in primary hyperparathyroidism

Background. Brown tumor occasionally affects the facial bones. Clinically, these lesions can be mistaken for a neo- plasm. Opinions are divided on the course of management of the bony lesions once parathyroidectomy has been carried out. Methods. We treated 22 patients with primary hyperparathy- roidism and osteitis fibrosa cystica and observed their clinical and biochemical recovery. Results. Fifteen patients (68.2%) had brown tumors in mandible, and 7 (31.8%) in maxilla. After parathyroidectomy, 21 patients had normal total serum calcium values. All brown tumors presented a spontaneous progressive regression; in 18 cases, regression was total, with a mean time period of 10 months. Two patients had partial regression after nearly 2 years. Another 2 patients were lost to follow-up. Conclusions. After successful parathyroid surgery, the bony lesions tended to regress spontaneously, either partially or com- pletely. However, if the lesion is disfiguring or symptomatic, sur- gical excision may be indicated. V C 2008 Wiley Periodicals, Inc. Head Neck 30: 1497-1504, 2008