Perawatan Brown Tumor pada Mandibula Pasien dengan Hiperparatiroid (HPT) Tersier

Agatha Tunggadewi Purnamasari; Arsa Hadiyatama Waskitoaji; Wisnu Riyadi; Bambang Tri Hartomo

doi:10.18196/di.v10i2.9301

Perawatan Brown Tumor pada Mandibula Pasien dengan Hiperparatiroid (HPT) Tersier

Agatha Tunggadewi Purnamasari, Arsa Hadiyatama Waskitoaji, Wisnu Riyadi, Bambang Tri Hartomo

Abstract

Hiperparatiroidisme (HPT) merupakan kondisi yang disebabkan oleh meningkatnya produksi dan sekresi hormon paratiroid (PTH). Tipe HPT diklasifikasikan menjadi tiga dan HPT tersier merupakan yang paling jarang terjadi. Kerusakan tulang merupakan komplikasi yang paling sering terjadi pada HPT tersier yaitu sebesar 25% dari total pasien HPT dan brown tumor merupakan salah satu bagian dari komplikasi tersebut. Lesi ini sering terjadi pada tulang kortikal, termasuk mandibula. Pemeriksaan klinis, radiografis, histopatologi, dan biokimia serum dilakukan dalam upaya diagnosis brown tumor. Perawatan brown tumor dilakukan melalui dua pendekatan yaitu bedah dan non-bedah. Tujuan dari penulisan telaah pustaka ini adalah menjelaskan pentingnya diagnosis dan perawatan yang tepat pada kondisi brown tumor pada mandibula oleh dokter gigi sehingga kerusakan yang lebih parah dapat dicegah. Pemilihan jenis perawatan lesi brown tumor yang tepat didapatkan melalui pemeriksaan yang komprehensif sehingga didapatkan hasil perawatan yang memuaskan. Telaah pustaka ini berjenis telaah pustaka naratif. Pencarian pustaka dilakukan melalui sumber elektronik seperti PubMed, Google Scholar, dan Clinical Key dengan kriteria inklusi dan eksklusi tertentu. Kesimpulan dari telaah pustaka ini adalah pemeriksaan klinis, laboratoris, histologis, serta radiografis yang baik menghasilkan diagnosis yang tepat sehingga dapat mencegah keparahan dan mengurangi kerusakan akibat lesi tersebut.

Keywords

Brown Tumor; Enukleasi; Hiperparatiroid; Hormon Paratiroid; Paratiroidektomi.

Full Text:

PDF

References

Nunes TB, Bologna SB, Witzel AL, Nico MMS, Lourenço SV. A Rare Case of Concomitant Maxilla and Mandible Brown Tumours, Papillary Thyroid Carcinoma, Parathyroid Adenoma, and Osteitis Fibrosa Cystica, Case Reports in Dentistry. 2016. https://doi.org/10.1155/2016/5320298

Choi JH, Kim KJ, Lee YJ, Kim SH, Kim SG, Jung KY, et al. Primary hyperparathyroidism with extensive brown tumors and multiple fractures in a 20-year-old woman, Endocrinology and Metabolism. 2015;30(4):614–619. https://doi.org/10.3803/EnM.2015.30.4.614

Singhal A, Chandra B, Seth S. Unusually Large Brown tumor of Mandible in a Case of Secondary Hyperparathyroidism Mimicking Cherubism, Indian Journal of Nuclear Medicine. 2019;33(2):359–362.

Talukder S, Behera A, Bhadada SK, Mitra S. Giant mediastinal parathyroid adenoma presenting as bilateral brown tumour of mandible: A rare presentation of primary hyperparathyroidism, British Medical Journal,2017;1–5. https://doi.org/10.1136/bcr-2017-220722

Palla B, Burian E, Fliefel R, Otto S. Systematic review of oral manifestations related to hyperparathyroidism, Clinical Oral Investigation.2018;22(1):1–28. https://doi.org/10.1007/s00784-017-2124-0

Brabyn P, Capote A, Belloti M, Zylberberg I. Hyperparathyroidism Diagnosed Due to Brown Tumors of the Jaw: A Case Report and Literature Review, Journal of Oral and Maxillofacial Surgery. 2017;75(10):2162–9. https://doi.org/10.1016/j.joms.2017.03.013

Jafari-Pozve N, Ataie-Khorasgani M, Jafari-Pozve N, Ataie-Khorasgani M, Ataie-Khorasgani M, Jafari-Pozve S. Maxillofacial brown tumors in secondary hyperparathyroidism: A case report and literature review. J Res Med Sci. 2014;19(11):1099–102.

Zou H, Song L, Jia M, Wang L, Sun Y. Brown tumor of multiple facial bones associated with primary hyperparathyroidism: A clinical case report., Medicine. 2018;97(33):1–4. https://doi.org/10.1097/MD.0000000000011877

Dorigatti De Ávila É, De Molon RS, Cabrini Gabrielli MA, Hochuli-Vieira E, Sgavioli Massucato EM, De Mello-Filho FV, et al. Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland, Journal of Cranio-Maxillofacial Surgery, 40(1):e19–23. https://doi.org/10.1016/j.jcms.2011.01.001

Guéroult AM, Cameron M. Rare brown tumour of the mandible secondary to tertiary hyperparathyroidism in a renal transplant recipient, British Medical Journal.2019;12(9):10–13. https://doi.org/10.1136/bcr-2019-231231

Effiom OA, Ogundana OM, Akinshipo AO, Akintoye SO. Ameloblastoma: current etiopathological concepts and management, Oral Disease. 2018; 24(3):307–316. https://doi.org/10.1111/odi.12646

Gulati D, Bansal V, Dubey P, Pandey S, Agrawal A. Central giant cell granuloma of posterior maxilla: First expression of primary hyperparathyroidism, Case Report of Endocrinology. 2015. https://doi.org/10.1155/2015/170412

Noleto J, Ramos IS, Rocha J, Garcia I. Salvador Roberto, B. A rare case of regression of brown tumors of tertiary hyperparathyroidism after parathyroidectomy and renal transplant: A 5-year follow-up, Annual Maxillofacial Surgery. 2016;6(1):125. 10.4103/2231-0746.186123

Baral R, Ojha B, Bajracharya D, Bhattacharyya S, Roy S, Singh S. Brown Tumour of Jaw Bone: A Diagnostic Attribute of Hyperparathyroidism, Journal of Nepal Society of Periodontology and Oral Implantology. 2017;1(2):72–74. https://doi.org/10.3126/jnspoi.v1i2.23553

Yucesoy T, Kilic E, Dogruel F, Bayram F, Alkan A, Akcan AC, et al. Spontaneous and Excellent Healing of Bilateral Brown Tumors in Mandible after Endocrinal Therapy and Subtotal Parathyroidectomy: Case Report with 4-Year Follow-Up, Case Report in Dentistry. 2018. https://doi.org/10.1155/2018/8070131

Lajolo C, Patini R, Limongelli L. Brown tumors of the oral cavity : presentation of 4 new cases and a systematic literature review. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 2020;129(6):575-584. https://doi.org/10.1016/j.oooo.2020.02.002

Selcuk AA. A Guide for Systematic Reviews: PRISMA, Turkish Arch Otorhinolaryngol, 2019;57(1):57–58. https://doi.org/10.5152/tao.2019.4058

Bezerra, Pinto, AS. Brown Tumor: A Late Complication of Secondary Hyperparathyroidism, Biomedical Journal of Science and Technology Research, 2018;6(3):5274–5277. https://doi.org/10.26717/BJSTR.2018.06.001351

Cozzolino M, Galassi A, Conte F, Mangano M, Di Lullo L, Bellasi A. Treatment of secondary hyperparathyroidism: The clinical utility of etelcalcetide, Therapeutics and Clinical Risk Management. 2017;13:679–689. https://doi.org/10.2147/TCRM.S108490

Elhafeez SA, Bolignano D, D’Arrigo G, Dounousi E, Tripepi G, Zoccali C. Prevalence and burden of chronic kidney disease among the general population and high-risk groups in Africa: A systematic review, British Medical Journal, 2018;8(1). http://dx.doi.org/10.1136/bmjopen-2016-015069

Popovik-Monevska D, Bozovik-Dvojakovska S, Popovski V, Benedetti A, Grchev A, Koneski F. 2018, Brown tumour in the mandible and skull osteosclerosis associated with primary hyperparathyroidism – a case report, Open Access Maced Journal of Medical Science, 6(2):406–409. https://doi.org/10.3889/oamjms.2018.086

Sia HK, Hsieh MC, Yang LH, Tu STe. 2012, Maxillary brown tumor as initial presentation of parathyroid adenoma: A case report, Kaohsiung Journal Medical Science. 2012;28(7):400–403. https://doi.org/10.1016/j.kjms.2012.02.008

Wilson JJ, Schwartz HC, Tehrany GM. 2013, Brown tumor of the posterior maxilla as initial manifestation of primary hyperparathyroidism: Case report, Journal of Oral and Maxillofacial Surgery, 71(5):886–890. https://doi.org/10.1016/j.joms.2012.11.013

Altay C, Erdogan N, Eren E, Altay S, Karasu S, Uluç E. 2013, Computed tomography findings of an unusual maxillary sinus mass: Brown tumor due to tertiary Hyperparathyroidism, Journal of Clin Imaging Science, 3(1):1–5. https://doi.org/10.4103/2156-7514.122325

Rao KRI, Priya NS, Rao K, Ashwin DP. 2016, Brown tumor of mandible in association with primary hyperparathyroidism, Indian Journal of Oral Science, 7(1):54. https://doi.org/10.4103/0976-6944.176385

Shindo M, Lee JA, Lubitz CC, McCoy KL, Orloff LA, Tufano RP, et al, 2016, The changing landscape of primary, secondary, and tertiary hyperparathyroidism: Highlights from the American College of Surgeons Panel, “what’s new for the surgeon caring for patients with hyperparathyroidism.”, J Am Coll Surg, 222(6):1240–1250. https://doi.org/10.1016/j.jamcollsurg.2016.02.024

Pechalova PF, Poriazova EG. 2013, Brown tumor at the jaw in patients with secondary hyperparathyroidism due to chronic renal failure, Acta Medica, 56(2):83–86. https://doi.org/10.14712/18059694.2014.29

Pati AR, Mubeen, Vijayalakshmi KR, Singh C. 2014, Diagnosis and clinico-radiological presentation in an aggressive maxillary brown tumour, Journal of Clinica; Diagnostic and Research, 8(5):13–15. https://doi.org/10.7860/JCDR/2014/7511.4358

Verma P, Verma KG, Verma D, Patwardhan N. 2014, Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity, Journal of Oral and Maxillofacial Pathology, 18(2):267–270. https://doi.org/10.4103/0973-029X.140779

Gedik GK, Ata O, Karabagli P, Sari O. 2014, Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass, Journal of Nuclear Medicine, 17(3):214–217. https://doi.org/10.1967/s002449910147

Can Ö, Boynueǧri B, Gökçe AM, Özdemir E, Ferhatoǧlu F, Canbakan M, et al. Brown Tumors: A Case Report and Review of the Literature, Case Reports Nephrol Dial. 2016;6(1):46–52. https://doi.org/10.1159/000444703

Masthan KMK, Anitha N, Krupaa J, Manikkam S. Ameloblastoma., Journal of Pharmatology Bioallied Science, 2015; 7(5): 167–170. https://doi.org/10.4103/0975-7406.155891

DOI: https://doi.org/10.18196/di.v10i2.9301