Peripheral Brown Tumor of the Jaws: Case Report and Literature Review

Background: Peripheral brown tumor is a rare extraosseous manifestation of hyperparathyroidism that can closely mimic peripheral giant cell granuloma (PGCG) in its clinical, radiographic, and histopathological presentation. Accurate diagnosis is essential because the treatment targets the underlying metabolic disorder rather than the lesion alone. Case Presentation: We report the case of a 38-year-old woman presenting with a painless, progressively enlarging gingival mass in the right maxillary vestibular region. Panoramic radiography revealed a localized osteolytic lesion beneath the soft tissue swelling. Histopathological examination demonstrated a multinucleated giant cell lesion with a fibrovascular stroma, suggesting either PGCG or a peripheral brown tumor. Further biochemical investigations showed markedly elevated serum parathyroid hormone (PTH) levels, confirming the diagnosis of a peripheral brown tumor associated with hyperparathyroidism. The lesion was surgically excised, and the patient was referred for endocrinological evaluation and treatment of the underlying endocrine disorder. Literature Review: A review of the published literature confirms that peripheral brown tumors of the jaws are exceptionally rare and frequently misdiagnosed because of their close resemblance to PGCG. Reported cases consistently emphasize the importance of correlating histopathological findings with biochemical investigations, particularly serum PTH levels, to establish the correct diagnosis and guide appropriate management. Conclusion: Peripheral brown tumor should always be considered in the differential diagnosis of giant cell lesions affecting the gingiva. Histopathology alone is insufficient to distinguish it from PGCG. A multidisciplinary approach integrating clinical, radiological, histological, and biochemical findings is essential for early diagnosis, appropriate treatment of hyperparathyroidism, and prevention of recurrence.