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

Figure 6

Parathyroid adenoma. (a) The patient underwent minimally invasive video-assisted parathyroidectomy (MIVAP) with intraoperative PTH determinations (baseline and 20 minutes after tumor removal) and continuous intraoperative nerve monitoring. A left inferior parathyroid adenoma was successfully removed. The baseline PTH measurement was 678 pg, and 20 minutes after excision the PTH serum level was 47 pg. Postoperative progress was uneventful. The patient was discharged the day after the operation with the appropriate prescriptions. (b and c) Parathyroid adenoma with clear cells at a low and high grade of amplification; a thin fibrous capsule is present. (d) CD34 endothelial staining showed no evidence of angioinvasion. (e) PTH staining confirmed the functional activity of the tumor. (f) Ki-67 expression was low, confirming the benign nature of the tumor.

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