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Dr. Leah Webb

Dr. Leah Webb

Cardiff University

Dr. Leah Webb is a Clinical Fellow in Oral and Maxillofacial Surgery with over two years of experience in OMFS and prior rotations in Oral Medicine, Oral Surgery, and Community Dental Services. She has published widely in journals including the British Dental Journal, Dental Update, and Taylor & Francis, with work focusing on clinical photography, supracrestal tissue attachment, and inter-professional learning in vulnerable populations. Her clinical and academic interests include oral mucosal disease, surgical dentistry, and interdisciplinary education.

United Kingdom

Abstracts

2025

When an implant site tells a bigger story: Brown tumour as the initial manifestation of hyperparathyroidism

Brown tumours are rare osteoclastic lesions that develop secondary to hyperparathyroidism, a metabolic disorder characterised by elevated parathyroid hormone (PTH) levels which disrupt calcium homeostasis. These lesions frequently affect bones such as the ribs, pelvis, and mandible, and may histologically resemble other giant cell lesions, making diagnosis challenging. This case report describes a 49-year-old woman who presented with a brown tumour at the site of a dental implant, which was the first clinical manifestation of primary hyperparathyroidism. The lesion manifested as a firm, tender swelling with central ulceration following implant removal. Radiographic examination revealed a radiolucent lesion with surrounding sclerosis, while histopathology confirmed a giant cell lesion.

Biochemical investigations demonstrated elevated PTH and serum calcium levels, confirming the diagnosis of hyperparathyroidism. It remains unclear whether the implant placement contributed to the development of the brown tumour at this site or if the occurrence was coincidental. The patient was promptly referred to endocrinology for further evaluation and management.

This case highlights the importance of including systemic metabolic disorders such as hyperparathyroidism in the differential diagnosis of oral giant cell lesions. Furthermore, it emphasises the critical role of dental professionals in recognising unusual oral findings, facilitating early diagnosis, and ensuring timely referral for appropriate multidisciplinary care.