Serviços Personalizados
Journal
Artigo
nova página do texto(beta)
Espanhol (pdf)
Artigo em XML
Referências do artigo
Tradução automática
Enviar este artigo por emailIndicadores
-
Citado por SciELO -
Acessos
Links relacionados
-
Similares em
SciELO
Compartilhar
Permalink
Revista odontológica mexicana
versão impressa ISSN 1870-199X
Rev. Odont. Mex vol.11 no.3 Ciudad de México Set. 2007
https://doi.org/10.22201/fo.1870199xp.2007.11.3.15807
Trabajos originales
Manifestación maxilofacial del hiperparatiroidismo
Maxilofacial manifestation of hyperparathyroidism
* Residente de último año Cirugía Maxilofacial. HECMNR. México.
§ Jefe de Servicio del Departamento de Cirugía Maxilofacial. HECMNR. México.
II Médico de Base del Servicio de Anatomía Patológica. HECMNR. México.
Objetivo
Analizar las manifestaciones clínicas del hiperparatiroidismo en el área de maxilofacial en el HECMNR.
Material y métodos
Diseño: Descriptivo, y observacional del 1 enero de 1999 a junio de 2004 en el Departamento de Cirugía Maxilofacial. Se revisaron 18 expedientes clínicos y los criterios de inclusión fueron: granuloma central de células gigantes como diagnóstico clínico inicial, pacientes derechohabientes del IMSS, con expediente clínico completo. De éstos se excluyeron 7 por expediente clínico incompleto. Del expediente se analizó: la edad, sexo, localización anatómica, tratamiento quirúrgico, exámenes de laboratorio y gabinete, reporte histopatológico definitivo.
Resultados
Se registraron 11 casos con diagnóstico clínico de granuloma central, sólo 2 (18.18%) presentaron hiperparatiroidismo, una mujer de 52 y un hombre de 62 años. Las lesiones se ubicaron en el cuerpo mandibular en ambos casos, la etiología se relacionó con adenoma paratiroideo. Fue necesario realizar paratiroidectomía parcial, solamente un caso continúa en control clínico radiográfico con disminución del tamaño del tumor.
Conclusiones
En las lesiones asociadas a hueso diagnosticadas clínicamente al inicio, como granulomas centrales de células gigantes en la región maxilofacial, se debe descartar hiperparatiroidismo primario, secundario o terciario. El tratamiento es la paratiroidectomía.
Palabras clave: Tumor pardo; granuloma central de células gigantes hiperparatiroidismo; paratiroidectomía
Objective
To analyze the clinical manifestation of hyperparathyroidism in the maxillofacial area at HECMNR.
Material and methods
Study design: Descriptive and observational study from January first 1999 to June 2004 in the Maxillofacial Surgery Department. Eighteen files were analyzed and inclusion criteria were central granuloma as clinical initial diagnosis, patients from IMSS with their complete file. Seven files were excluded. From clinical files the age, sex, anatomic location, surgical treatment, laboratory tests and histopathology study were analyzed.
Results
Eleven cases with central granuloma as a clinical diagnosis were registered, hyperparathyroidism was present only in two cases (18.18%), a 52 years old female and a 62 years old male. Lesions were located in the mandibular body in both cases, etiology was related with parathyroid adenoma. Partial parathyroidectomy was necessary, only one case is still in clinical and radiographic observation with involution size of the tumor.
Conclusions
Lesions associated to bone with giant cell granuloma as a clinical initial diagnosis in maxillofacial area, hyperparathyroidism has to be discarded. Type has to be confirmed. Parathyroidectomy being the treatment of choice.
Keywords: Brown tumor; hyperparathyroidism; parathyroidectomy; giant cell granuloma; parathyroid adenoma
Referencias
1. Auclair P, Arendt D, Hellstein J, Surgical pathology: Fibro-osseous diseases. Giant cell lesions of the jaws. Oral and Maxillofacial Surgery Clinics of North America 1997: 655-680. [ Links ]
2. Regezi J, Sciubba J. Oral pathology: Clinical pathologic correlations. Saunders, 1995: 461-465. [ Links ]
3. Smith AC, Bradley JC. Non surgical management of hyperparathyroidism of the jaws. J Oral and Maxillofacial Surgery 1987; 45: 176-181. [ Links ]
4. Okada H, Davies J, Yamamoto H. Brown tumor of the maxilla in a patient with secondary hyperparathyroidism: A case study involving immunohistochemistry and electron microscopy. J Oral and Maxillofacial Surg 2000; 58: 233-238. [ Links ]
5. Dilip K, Sushil KG, Amit A, Saroj M. Brown tumor of palate and mandible in association with primary hyperparathyroidism. J Oral and Maxillofacial Surgery 2001; 59: 1352- 1354. [ Links ]
6. Silverstein K, Adams C, Fonseca RJ. Evaluation and management of renal failure and dialysis patient, management of medical problems. Oral and Maxillofacial Surgery Clinics of North America 1998: 417-427. [ Links ]
7. Yamazaki H, Ota Y, Karakida K. Brown tumor of the maxilla and mandible: Progressive mandibular brown tumor after removal parathyroid adenoma. J Oral and Maxillofacial Surgery 2003; 61: 719-722. [ Links ]
8. Smith B, Fowler C, Svane T. Primary hyperparathyroidism presenting a “Peripheral” giant cell granuloma. J Oral and Maxillofacial Surgery 1988; 49: 65-69. [ Links ]
9. Vikram H, Petito A, Bower B, Goldberg M. Parathyroid carcinoma on basis of giant lesion of the maxilla. J Oral and Maxillofacial Surgery 2000; 58: 567-569. [ Links ]
10. Kennet S, Pollick H. Jaw lesions in familial hyperparathyroidism. J Oral Surg 1971; 31: 502-510. [ Links ]
11. Jeffery CB, Stewart. Surgical pathology. Oral and Maxillofacial Surgery. Raymond Fonseca. Saunders; 2000: 409-411. [ Links ]
12. Coleman RD. Giant cell tumor of mandible associated with hyperparatiroidism and osteitis fibrosa cystica generalisata. Cancer and precancer Oral. Pindborg. Editorial Medica Panamericana 1978: 534-541. [ Links ]
13. Bataineh A, Al-Khateeb T, Rawashdeh M. The surgical treatment of central giant cell granuloma of the mandible. J Oral and Maxillofacial Surgery 2002; 60: 756-761. [ Links ]
14. Marx SJ. Hyperparathyroid and hypoparathyroid disorders. The New England Journal of Medicine 2000; 25: 1863-1875. [ Links ]
15. Peña ML, Soriano F, Díaz de León L, Robles P. Tumor pardo del hiperparatiroidismo en maxilar y mandíbula. Reporte de un caso. Revista ADM 2002; LIX: 63-66. [ Links ]
16. Pogrel M. A. Calcitonin therapy for central giant cell granuloma. J Oral and Maxillofacial Surgery 2003; 61: 649-653. [ Links ]
Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons
