Surgical approach of brown maxillary tumor in Sagliker syndrome

Abstract

Case presentation. This is a 20-year-old female patient with stage 5 chronic kidney disease on hemodialysis who noticed progressive enlargement of the palatal region in the last seven months, which generated dyslalia and difficulty in chewing with expansion of the maxillary bone, separation of the upper teeth and changes in the facial configuration and profile compatible with a brown tumor. Laboratory results confirmed hyperparathyroidism and hypocalcemia secondary to renal disease. Ultrasound findings were compatible with left-sided parathyroid hyperplasia. Treatment. Calcium carbonate and paricalcitol were administered during the two weeks prior to surgery. The treatment consisted of subtotal parathyroidectomy and surgical resection of the tumor in the maxilla and oral calcium and vitamin D3 supplements. Outcome. Calcium and phosphorus levels normalized and parathyroid hormone levels decreased. After a follow-up of more than two years, no recurrences were identified.