Expansive renal osteitis fibrosa: a case report

Oral Maxillofac Surg. 2018 Sep;22(3):323-327. doi: 10.1007/s10006-018-0697-7. Epub 2018 May 4.

Abstract

Hyperparathyroidism (HPT) is an endocrine metabolic disorder characterized by increased secretion of parathyroid hormone. Untreated secondary HPT leads to renal osteodystrophy (ROD). Facial skeletal abnormalities in patients with ROD are rare. The purpose of this paper is to report a conservative surgical approach of exuberant osteitis fibrosa lesions in patient with chronic kidney disease. A 24-year-old female was referred to maxillofacial surgery department with giants ROD affecting palate, maxilla, and mandible, resulting in esthetic and functional impairment. The pathogeneses and multidisciplinary management of ROD are discussed with a brief literature review. Eight years after the conservative treatment of exuberant jaw lesions, no noticeable bone changes were observed in the patient. A multidisciplinary therapy is essential for correct diagnosis of ROD and optimal multimodality treatment. The conservative management was an efficient alternative for the success of the case reported.

Keywords: Chronic kidney disease; Hyperparathyroidism; Maxillary diseases; Renal osteodystrophy; Secondary hyperparathyroidism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Chronic Kidney Disease-Mineral and Bone Disorder / etiology*
  • Diagnosis, Differential
  • Esthetics, Dental
  • Female
  • Humans
  • Hyperparathyroidism, Secondary / complications*
  • Imaging, Three-Dimensional
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / etiology*
  • Mandibular Diseases / surgery*
  • Maxillary Diseases / diagnostic imaging
  • Maxillary Diseases / etiology*
  • Maxillary Diseases / surgery*
  • Oral Surgical Procedures / methods*
  • Osteitis Fibrosa Cystica / etiology*
  • Osteitis Fibrosa Cystica / surgery*
  • Palate / diagnostic imaging
  • Palate / pathology*
  • Palate / surgery*
  • Surgical Flaps
  • Tomography, X-Ray Computed
  • Young Adult