Primary hyperparathyroidism presenting as a palatal brown tumor

Only 2% of all primary hyperparathyroidism cases occur in patients below the age of 30 years. Owing to the improved methods of blood analysis in the last 2 decades, most of the recent cases of primary hyperparathyroidism are diagnosed early and asymptomatically. This makes advanced disease with bone lesions extremely rare these days. A case of a 25-year old female patient with previously undiagnosed primary hyperparathyroidism who presented first with palatal swelling is reported. Further investigations revealed parathyroid adenoma, nephrocalcinosis, and extensive bone lesions involving the maxillary sinus and palate as well as the pelvic bone. The evaluation of the hyperparathyroid patient is reviewed in this report. The methods of treatment of the bony lesions of primary hyperparathyroidism are also discussed.