Written By-: Kapil Gaur

A team of surgeons and medical professionals at AIIMS, New Delhi, successfully operated on a young girl who was suffering from a massive jaw tumour associated with hyperparathyroidism, a rare endocrine disorder. The surgery, which was a collaborative effort between surgical disciplines and oral and maxillofacial surgery, was conducted by Head of Department of Surgery, Dr. Sunil Chumber, and Head of Oral & Maxillofacial Surgery, Dr. Ajoy Roychoudhury.

The parathyroid gland, which is located in the neck, plays a crucial role in maintaining the calcium and phosphate balance in the human body. The gland secretes parathyroid hormone (PTH), which regulates calcium levels in the blood. Dr. Sunil Chumber, says that hyperparathyroidism is a condition that causes the parathyroid gland to produce excess parathyroid hormone, leading to an increase in calcium levels in the blood. This can cause a range of symptoms, including weakness, fatigue, and bone pain. In rare cases, it causes tumours to grow in the bones or soft tissues of the body. If these tumours are detected in time, they are completely cured surgically and may avoid other complications.

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This 14-year-old young girl had developed a giant cell tumor of the jaw, which had grown to an enormous size, causing significant facial disfigurement and difficulty eating and speaking. Dr. Ajoy Roychoudhury, Head of Oral & Maxillofacial Surgery at AIIMS, explained that the tumour is a rare type that is usually benign. He said, “It was very risky in terms of bleeding and risk of causing permanent damage to her ability to eat or speak, but we were able to manage well with accurate planning and a great team.

Jaw tumors caused by hyperparathyroidism are a rare but serious complication of the condition. These tumors are usually benign and slow-growing, but they can cause significant destruction of the jawbone, leading to pain, swelling, and disfigurement. If left untreated, they can also cause the loss of teeth and even fractures of the jaw bone. Many times if the parathyroid adenoma is left untreated the entire jaw bone can show the spread of tumor and can be lost in due course causing severe debility.

Dr. Rijuta Aphale and Dr. Gopal Puri emphasized the importance of early detection and treatment of hyperparathyroidism to avoid the development of such tumours and other related conditions. It is important to get tested for high PTH levels when faced with large jaw tumors or other symptoms of hyperparathyroidism. Dr. Suraj Premanand enlightens us that this tumour is by far in literature noted to be the largest jaw tumour associated with hyperparathyroidism to our knowledge.

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A teamwork at AIIMS between Endocrine Surgery and Oral & Maxillofacial Surgery, Radiodiagnosis, Nuclear medicine and pathology and anesthesiology and helped the patient to regain a normal life. Her tumors were diagnosed using modern radiology and nuclear medicine diagnostic methods led by Dr. Devasenapathy and Dr. Nishikant Damle. She was operated on for parathyroid adenoma by a team of surgeons led by Prof. Sunil Chumber and her jaw tumor excision and reconstruction were performed by Prof. Ajoy Roychoudhury and Prof. Ongkila Bhutia. The patient has started to eat and is leading a healthy and normal life. This teamwork at AIIMS has helped her restore her quality of life. This case emphasizes the team work and dedication, which AIIMS is well known for.