Evidence Based Solving Approach in Diagnosis of Primary Hyperparathyroidism with Oral Manifestations: Report of Three Unusual Cases
A 32-year-old female patient reported with complaint of swelling over the front right side of the lower jaw since 2 months with history of a small painful swelling over the chin region which gradually increased to the present size []. Patient also gave history of joint pain, backache, and weakness and renal stones 2 years back.\nExtraoral examination revealed a well-defined, soft to firm and tender swelling over the mental and right body of mandible of 6 × 4 cm in size which extended anteroposteriorly from left parasymphysis to the right mandibular body and superoinferiorly from the level of vermilion border of lower lip to the submental region [; inset]. Detailed intraoral examination revealed obliteration of labial vestibule i.r.t 41-45 region with Grade 1 mobility of involved teeth. Radiographic examination revealed irregular radiolucency with ill-defined margins seen in the mandible extending from 35-45 region. Generalized rarefaction of the trabeculae and altered trabecular pattern was also seen along with generalized loss of lamina dura []. Full mouth intraoral periapical (IOPA) survey revealed generalized loss of lamina dura. Computed tomography (CT) scan examination revealed gross bone destruction with soft tissue mass.