Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Dentistry
Volume 2017, Article ID 9604570, 8 pages
https://doi.org/10.1155/2017/9604570
Case Report

A Giant-Cell Lesion with Cellular Cannibalism in the Mandible: Case Report and Review of Brown Tumors in Hyperparathyroidism

1Department of Surgical and Morphological Sciences, University of Insubria, ASST dei Sette Laghi, Unit of Oral Pathology, Dental Clinic, Varese, Italy
2Department of Surgical and Morphological Sciences, University of Insubria, ASST dei Sette Laghi, Unit of Pathologic Anatomy, Varese, Italy
3Department of Surgical and Morphological Sciences, University of Insubria, ASST dei Sette Laghi, Unit of General Surgery 1, Varese, Italy
4Meditel, Medical Centre, Unit of Radiology, Saronno, Italy

Correspondence should be addressed to Lorenzo Azzi; moc.liamtoh@68izzaoznerol

Received 14 November 2016; Revised 2 January 2017; Accepted 16 January 2017; Published 9 February 2017

Academic Editor: Junichi Asaumi

Copyright © 2017 Lorenzo Azzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A small radiolucent area in the mandible was discovered in a 58-year-old woman with no oral complaints. The patient’s history included only hypertension. The lesion was considered as an inflammatory cyst and was enucleated. Three months later, a CT revealed the presence of a cyst-like lesion in the mandible with thin expanded buccal cortical plate, localized erosion, and a polylobate appearance on the lingual aspect of the cortical plate. The histological diagnosis of the lesion was central giant-cell granuloma (CGCG). The lesion was thoroughly enucleated. Nevertheless, another X-ray carried out six months later revealed multiple bilateral osteolytic areas throughout the jaw. In addition, widespread cortical plate erosion was observed, as well as signs of root resorption and periodontal enlargement. There was no sign of neurological involvement, although the nerves appeared to be dislocated. After full blood chemistry analysis and detailed collection of radiographs, the final diagnosis was brown tumors in primary hyperparathyroidism. This case report demonstrates how dental clinicians may be the first-line specialists who identify a complex systemic disease before other clinicians. Finally, it highlights the role of cellular cannibalism in predicting the clinical aggressiveness of brown tumors as well as in other giant-cell lesions.