{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T04:24:02Z","timestamp":1778819042524,"version":"3.51.4"},"reference-count":23,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,29]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>We report a rare case of maxillary and mandibular involvement by multiple brown tumours in a patient with primary hyperparathyroidism (PHPT). The patient presented with painless jaw swelling and a pathological fracture of the right humerus. Radiographic evaluation demonstrated multiple osteolytic lesions in the maxilla, mandible and skull. Biochemical investigations revealed severe hypercalcaemia and markedly elevated intact parathyroid hormone (iPTH), and four-dimensional CT confirmed a right inferior parathyroid adenoma. Histopathology, together with negative H3G34W immunohistochemistry, established the diagnosis of brown tumours. Preoperatively, denosumab was administered to control hypercalcaemia, and the patient subsequently underwent targeted parathyroidectomy. Postoperatively, the patient had normalisation of iPTH levels, with regression of the brown tumours over 6\u2009months. This case emphasises the importance of considering PHPT in patients presenting with jaw swelling and highlights the value of a multidisciplinary approach in diagnosis and management.<\/jats:p>","DOI":"10.1136\/bcr-2025-267407","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T08:40:12Z","timestamp":1766133612000},"page":"e267407","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Multiple brown tumours in the maxillofacial region as the initial presentation of primary hyperparathyroidism"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7016-6802","authenticated-orcid":false,"given":"Mohd Aswad","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Burns, Plastic and Maxillofacial Surgery, VMMC and SJH, New Delhi, DL, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7533-8726","authenticated-orcid":false,"given":"Ahmad","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Jawaharlal Nehru Medical College and Hospital, Aligarh, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajjad Abdur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dr Ziauddin Ahmad Dental College, Aligarh, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Otorhinolayngology, Jawaharlal Nehru Medical College, Aligarh, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4323-8003","authenticated-orcid":false,"given":"Aafiya","family":"Ambereen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dr Ziauddin Ahmad Dental College, Aligarh, UP, India"},{"name":"Department of Oral And Maxillofacial Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"2025121900400674000_18.12.e267407.1","first-page":"100370","article-title":"Aggressive Brown tumors of the maxilla and mandible post-parathyroidectomy in chronic renal failure: A case report and literature review","volume":"10","author":"Abbasi","year":"2024","journal-title":"Oral Maxillofac Surg"},{"key":"2025121900400674000_18.12.e267407.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2005.11.004"},{"key":"2025121900400674000_18.12.e267407.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0709(96)90075-7"},{"key":"2025121900400674000_18.12.e267407.4","unstructured":"Neville BW , Damm DD , Allen CM , et al . 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