[Medical parathyroidectomy. Its efficacy in treatment of lower maxillary brown tumor]

A patient with end-stage renal disease, hemodialysis treatment, severe secondary hyperparathyroidism and mandibular brown tumor received increasing doses of oral calcitriol (3.5 to 9 micrograms/week) and calcium carbonate (10 g/day). Nineteen months after the treatment, clinical, radiological and humoral improvement were observed. The present case demonstrates the effectiveness of medical parathyroidectomy for the control of severe secondary hyperparathyroidism--brown tumor--in chronic hemodialysed patients. This procedure should be considered as choice treatment keeping surgical parathyroidectomy for cases in which it is contraindicated such as hyperphosphoremia and/or controlled hypercalcemia or failure of the former procedure.