PRIMARY HYPERPARATHYROIDISM PRESENTING AS UNILATERAL EXOPHTHALMOS

Abstract

Primary or secondary hyperparathyroidism can present with a brown tumor of the mandible. Involvement of other skull and facial bones is extremely rare. Only a few cases with brown tumor of the orbital bones have been reported. An IS year old girl with primary hyperparathyroidism presented with unilateral exophthalmos caused by brown tumor of the orbital roof, lite patient had a 1.5 cm palpable parathyroid adenoma and significant widespread hyperparathyroid bone disease. After parathyroid excision and excision of the brown tumor of the orbit, the patient has remained asymptomatic and normocalcemic daring a 16 year follow-up. The bone lesions of hyperparathyroidism have completely healed. this report documents brown tumor of primary hyperparathyroidism as a rare cause of unilateral exophthalmos, prolonged follow-up after excision of the parathyroid adenoma showed heating of associated skeletal lesions, a fimling ruling out other conditions in this patient. A Medline search in August 1996 revealed fewer than 12 similar case reports. Although brown tumor of the orbit due to secondary or primary hyperparathyroidism is rare, giant cell tumor of the orbit shoulti be considered in patients with orbital tumors presenting with unilateral proptosis.