Perioperative management of a patient with brown tumour presenting with severe hypercalcaemia

Brown tumours represent a rare manifestation of hyperparathyroidism, with mandibular involvement being exceptionally uncommon. We present a challenging case of a woman in her early 30s with primary hyperparathyroidism presenting as a large mandibular brown tumour for parathyroidectomy, complicated by severe hypercalcaemia and difficult airway management. This case highlights the complex anaesthetic considerations required when significant metabolic derangement meets anatomical challenges, emphasising the importance of meticulous perioperative management.