Turkiye Klinikleri Journal of Dental Sciences

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Mandibulada Görülen Brown Tümörün D-Vitamini Kullanımı ile Takibi: Nadir Bir Olgu Sunumu
Follow-Up of Brown Tumor in Mandible with Vitamin-D Use: A Rare Case Report
Merve YELKEN KENDİRCİa, Ahmet Faruk ERTÜRKa, İlknur ÖZCANa
aİstanbul Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Radyolojisi ABD, İstanbul, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(3):705-8
doi: 10.5336/dentalsci.2021-87766
Article Language: TR
Full Text
ÖZET
 Vücuttaki kalsiyum metabolizmasını düzenleyen ana hormonlardan biri paratiroid hormonudur (PTH). Hiperparatiroidizm (HPT), PTH'nin paratiroid bezlerinden giderek daha fazla salgılandığı bir durumdur. Nadir olarak çenelerde fibrovasküler stroma ve dev hücrelerden oluşan yumuşak doku ile dolu osteolitik, kistik benzeri lezyonlar görülebilir. Dev hücreli granüloma gibi bu tür lezyonlar HPT ile ilişkili olduğunda Brown tümör olarak kabul edilir. Brown tümör, tüm HPT vakalarının sadece %0,1'inde bulunan nadir osteolitik lezyonlardır. Dev hücreli granüloma tanısıyla kliniğimize gelen 44 yaşındaki kadın hastanın 2019 yılındaki panoramik radyografisinde, 44 no.lu dişin mezialinden 36 no.lu diş bölgesine ulaşan düzenli radyoopak sınırlı lobüler radyolüsent lezyon görülmüştür. Dev hücreli granülom tanısı alan hastamızın kan değerleri endokrinoloji ile konsülte edildiğinde, PTH: 125,8 ng/L (12-88), Ca: 9,8 mg/DL (8,8-10,6), 25-hidroksi vitamin D: 21,06 ng/mL (30-100) olduğu görülmüş olup, endokrinoloji tarafından D-vitamini takviyesi başlatılmıştır. Brown tümörün primer tedavisi biyokimyasal değerleri düzeltmek olmalıdır. Bu olguda da kan değerleri düzeltilmeye çalışılarak takip yapılmıştır.

Anahtar Kelimeler: Kemiğin dev hücreli tümörü; xxxhiperparatiroidizm; paratiroid hormonu
ABSTRACT
 One of the main hormones that regulate calcium metabolism in the body is the parathyroid hormone (PTH). Hyperparathyroidism (HPT) is a condition in which PTH is increasingly secreted from the parathyroid glands. Rarely, osteolytic, cystic-like lesions filled with fibrovascular stroma and soft tissue composed of giant cells can be seen in the jaws. Such lesions, such as giant cell granuloma, are considered Brown tumors when associated with HPT. Brown tumors are rare osteolytic lesions found in only 0.1% of HPT cases. A panoramic radiograph of a 44-year-old female patient who came to our clinic to diagnose giant cell granuloma in 2019 showed a regular radiopaque limited lobular radiolucent lesion reaching from the mesial of tooth 44 to tooth region 36. When the blood values of our patient diagnosed with giant cell granuloma were consulted with the endocrinology, PTH: 125.8 ng/L (12-88), Ca: 9.8 mg/DL (8.8-10.6), 25-hydroxy vitamin D: 21, it was found to be 06 ng/mL (30-100) and D-vitamin supplementation was started by endocrinology. The primary treatment of the Brown tumor should be to correct the biochemical values. In this case, follow-up was done by correcting the blood values.

Keywords: Giant cell tumor of bone; hyperparathyroidism; parathyroid hormone
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