Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia

This case report describes a 14 year old girl presenting with progressive left jaw swelling and hypercalcemia. Imaging revealed an expansile, lytic mandibular mass with cortical thinning, initially suspected to be a central giant-cell lesion. Laboratory findings showed elevated calcium (12.6 mg/dL) and parathyroid hormone (PTH) levels (396 pg/mL), confirming primary hyperparathyroidism. Further evaluation identified a parathyroid adenoma. The mandibular lesion was diagnosed as a brown tumor a non neoplastic complication of hyperparathyroidism characterized by osteoclast rich bone resorption. Genetic testing ruled out familial syndromes (e.g., hyperparathyroidism jaw tumor syndrome). Treatment included enucleation of the mandibular mass and parathyroidectomy, leading to resolution of hypercalcemia and restoration of jaw contour. The case highlights the interplay between metabolic bone disease and localized skeletal manifestations in pediatric patients.

This case report describes a 14 year old girl presenting with progressive left jaw swelling and hypercalcemia. Imaging revealed an expansile, lytic mandibular mass with cortical thinning, initially suspected to be a central giant-cell lesion. Laboratory findings showed elevated calcium (12.6 mg/dL) and parathyroid hormone (PTH) levels (396 pg/mL), confirming primary hyperparathyroidism. Further evaluation identified a parathyroid adenoma. The mandibular lesion was diagnosed as a brown tumor a non neoplastic complication of hyperparathyroidism characterized by osteoclast rich bone resorption. Genetic testing ruled out familial syndromes (e.g., hyperparathyroidism jaw tumor syndrome). Treatment included enucleation of the mandibular mass and parathyroidectomy, leading to resolution of hypercalcemia and restoration of jaw contour. The case highlights the interplay between metabolic bone disease and localized skeletal manifestations in pediatric patients.