Smeđi tumor mandibule – moguća klinička manifestacija primarnog hiperparatireoidizma

  • Andrijana Milankov University Clinical Center of Vojvodina, Clinic for Endocrinology Diabetes and Metabolic Diseases, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Milena Mitrović University Clinical Center of Vojvodina, Clinic for Endocrinology Diabetes and Metabolic Diseases, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Tijana Icin University Clinical Center of Vojvodina, Clinic for Endocrinology Diabetes and Metabolic Diseases, Novi Sad, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Branislav Bajkin University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Dentistry Clinic of Vojvodina, Novi Sad, Serbia
  • Vukadin Milankov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP220809004M
Ključne reči: kosti, endokrine bolesti;, dijagnoza;, tumor gigantskih ćelija;, hiperparatireoidizam;, mandibula

Sažetak


Uvod. Jedna od mogućih manifestacija primarnog hiperparatireoidizma (PHPT) jeste pojava benignog tumora koštanog tkiva. Prikazana je mlada žena kod koje je prva klinička manifestacija PHPT bila smeđi tumor mandibule. Prikaz bolesnika. Bolesnica stara 27 godina bila je hospitalizovana na Klinici za endokrinologiju, dijabetes i metaboličke bolesti zbog tegoba u vidu mučnine, iscrpljenosti, osećaja gušenja, otežanog gutanja, bola u desnom uhu i desnoj polovini obraza, sa sumnjom na PHPT. Početni laboratorijski nalazi ukazivali su na visoke nivoe paratireoidnog (PT) hormona (PTH) i jona kalcijuma (Ca2+), nizak nivo vitamina D, kao i povišene vrednosti parametara koštanog metabolizma, sa znacima osteopenije. Kompjuterizovanom tomografijom konusnog zraka utvrđeno je bilateralno rasvetljenje u donjoj vilici. Scintigrafijom je potvrđeno prisustvo promene, retrosternalno, koja je mogla odgovarati adenomu PT žlezde. Nakon sprovedene paratireoidektomije, došlo je do normalizacije vrednosti PTH, parametara koštanog metabolizma i vrednosti Ca2+. Četiri meseca nakon paratireoidektomije, potvrđena je, klinički i radiološki, značajna regresija tumefakcije donje vilice. Zaključak. Smeđi tumori su retka prva klinička manifestacija PHPT. Zbog njihove patohistološke sličnosti sa drugim gigantocelularnim tumorima, postavljanje definitivne dijagnoze je nekada teško i zasniva se na korelaciji patohistološkog, radiološkog i laboratorijskog nalaza. S obzirom na to da nakon izlečenja PHPT dolazi do sponatne regresije lezija u kosti, smeđi tumori bi trebalo da budu razmotreni u diferencijalnoj dijagnozi svih gigantocelularnih lezija, kako bi se izbegao nepotreban hirurški tretman.

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Objavljeno
2023/11/02
Broj časopisa
Vol. 80 Br. 10 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika