Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman

Ismail El Bekkai; Lina Maalani; Orgi Anas; Hasna Belgadir; Aicha Merzem; Omar Amriss; Nadia Moussali; Naima El Benna

doi:10.5455/ajdi.20260404030946

A J Diagn Imaging. 2026; 12(3): 139-142

doi: 10.5455/ajdi.20260404030946

Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman

Ismail El Bekkai, Lina Maalani, Orgi Anas, Hasna Belgadir, Aicha Merzem, Omar Amriss, Nadia Moussali, Naima El Benna.

Abstract
Brown tumors are rare benign osteolytic lesions resulting from excessive osteoclastic activity in the setting of hyperparathyroidism. They occur in approximately 1.5–4.5% of patients with primary or secondary hyperparathyroidism and may occasionally represent the initial manifestation of the disease. We report the case of a 31-year-old woman who presented with progressive left facial swelling and mandibular deformity. Laboratory investigations revealed severe primary hyperparathyroidism with marked hypercalcemia and significantly elevated parathyroid hormone levels.
Computed tomography demonstrated multifocal osteolytic lesions involving both the maxilla and mandible, associated with diffuse craniofacial demineralization displaying a characteristic “salt-and-pepper” appearance. Additional lesions were identified in the ribs and humerus, together with a right inferior parathyroid adenoma. The diagnosis of multifocal brown tumors secondary to primary hyperparathyroidism was established based on the combination of clinical, biochemical, and imaging findings. Surgical excision of the adenoma resulted in normalization of biochemical parameters and progressive regression of the mandibular lesion.
This case is noteworthy because of the unusual coexistence of multiple maxillomandibular brown tumors with multifocal skeletal involvement in a young patient. It highlights the pivotal role of imaging in suggesting the diagnosis and preventing misinterpretation as metastatic bone disease or other giant-cell lesions.

Key words: brown tumors hyperparathyroidism adenoma mandibular osteolytic

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How to Cite this Article

Pubmed Style

Bekkai IE, Maalani L, Anas O, Belgadir H, Merzem A, Amriss O, Moussali N, Benna NE. Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. A J Diagn Imaging. 2026; 12(3): 139-142. doi:10.5455/ajdi.20260404030946

Web Style

Bekkai IE, Maalani L, Anas O, Belgadir H, Merzem A, Amriss O, Moussali N, Benna NE. Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. https://www.wisdomgale.com/ajdi/?mno=316366 [Access: August 04, 2026]. doi:10.5455/ajdi.20260404030946

AMA (American Medical Association) Style

Bekkai IE, Maalani L, Anas O, Belgadir H, Merzem A, Amriss O, Moussali N, Benna NE. Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. A J Diagn Imaging. 2026; 12(3): 139-142. doi:10.5455/ajdi.20260404030946

Vancouver/ICMJE Style

Bekkai IE, Maalani L, Anas O, Belgadir H, Merzem A, Amriss O, Moussali N, Benna NE. Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. A J Diagn Imaging. (2026), [cited August 04, 2026]; 12(3): 139-142. doi:10.5455/ajdi.20260404030946

Harvard Style

Bekkai, I. E., Maalani, . L., Anas, . O., Belgadir, . H., Merzem, . A., Amriss, . O., Moussali, . N. & Benna, . N. E. (2026) Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. A J Diagn Imaging, 12 (3), 139-142. doi:10.5455/ajdi.20260404030946

Turabian Style

Bekkai, Ismail El, Lina Maalani, Orgi Anas, Hasna Belgadir, Aicha Merzem, Omar Amriss, Nadia Moussali, and Naima El Benna. 2026. Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. American Journal of Diagnostic Imaging , 12 (3), 139-142. doi:10.5455/ajdi.20260404030946

Chicago Style

Bekkai, Ismail El, Lina Maalani, Orgi Anas, Hasna Belgadir, Aicha Merzem, Omar Amriss, Nadia Moussali, and Naima El Benna. "Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman." American Journal of Diagnostic Imaging 12 (2026), 139-142. doi:10.5455/ajdi.20260404030946

MLA (The Modern Language Association) Style

Bekkai, Ismail El, Lina Maalani, Orgi Anas, Hasna Belgadir, Aicha Merzem, Omar Amriss, Nadia Moussali, and Naima El Benna. "Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman." American Journal of Diagnostic Imaging 12.3 (2026), 139-142. Print. doi:10.5455/ajdi.20260404030946

APA (American Psychological Association) Style

Bekkai, I. E., Maalani, . L., Anas, . O., Belgadir, . H., Merzem, . A., Amriss, . O., Moussali, . N. & Benna, . N. E. (2026) Multifocal Maxillomandibular Brown Tumors Associated with Primary Hyperparathyroidism: Imaging Findings and Diagnostic Challenges in a Young Woman. American Journal of Diagnostic Imaging , 12 (3), 139-142. doi:10.5455/ajdi.20260404030946