Normocalcemic hyperparathyroidism manifesting as brown tumor of mandible: A case report

Patients with primary hyperparathyroidism (HPT) may be asymptomatic and clinical presentation of the tumor in the jaws can be the first sign of the disease. Only 2% of all primary HPT cases occur in patients below the age of 30 years. [1] Owing to the improved methods of blood analysis in the last two decades, most of the recent cases of primary HPT are diagnosed early and asymptomatically. [2] Most cases of primary HPT are identified by hypercalcemia and hypophosphatemia on routine multi-panel serum testing. [3] This makes advanced disease with brown tumor extremely rare these days, the mandible being affected only in 4% of the cases. [2] Here, we report a case of a 23-year-old female patient who presented with a swelling at body of mandible, with hypophosphatemia, increased parathyroid hormone, and normal serum calcium levels based on which a diagnosis of brown tumor was given.