 Hello, everyone. Welcome back to a new session on dentistry and more. So let's continue our tumors and oral pathology So far we covered Calcifying epithelial odendogenic tumor or C.E.O.T. and adenomatoid odendogenic tumor What is tumor is related to parotid gland or salivary gland? Brown tumor is a Parathyroidism condition So let's get into details of what is tumor and brown tumor So what is tumor and brown tumor? So what is tumor is exclusively on parotid gland and brown tumor is a hyperparathyroidism condition So whatever I put in this book is based on the university question paper Not exactly based on the syllabus or chapter-wise So let's see what is Warton's tumor? Warton's tumor is also known as papillary cyst adenoma lymphatoxin or adenolymphoma It is a exclusively a parotid gland tumor So it Prices of 14 percentage of salivary gland neoplasm and it is a benign tumor It is a second most common tumor after pleomorphic adenoma So while coming to the etiological factors smoking is one of the Significant etiological factors for Warton's tumor and next is radiation Well moving on to the clinical features this most common Seen in the seventh decade of life and it has a male predilection slight male predilection 1.1 1.5 to 1 ratio with females and it is a most commonly uni lateral lesion But in 10 percentage cases it is bilaterally placed and Common site is the tail of parotid gland and it is one of the very few tumors Which is exclusively present in parotid gland And it has very rare malignant potential. It is most commonly a benign lesion So it's clinical presentation. It is an encapsulated smooth low bladed surface with a soft Flecture and compressible mass and The cystic spaces of variable size with viscous fluid and a shaggy epithelium And the solid areas with white nodules representing the lymphoid follicles so In clinical features it is in seventh decade male predilection Unilateral 10% cases is bilateral Tail of parotid is common site. It is encapsulated a smooth low bladed surface with a fluctuating and compressible Lesion with cystic spaces of variable size with viscous fluid and a shaggy epithelium So this solid White nodules representing lymphoid follicles Well coming to the histology. We can put a Acroning whale that is what in has abundant lymphoid and epithelial components The characteristic feature in histology is a papillary projection. That is why it is what this name papillary system, you know my lymphotosome The projections into cystic spaces. So there will be papillary projections which is seen in Cystic spaces which is surrounded by lymphoid stroma and the epithelium is double layered Which is luminal cell and a basal cell and the stroma is including mature lymphoid follicles with germinal centers So this is Histological part we can say it has a whale that is what in has abundant lymphoid and epithelial components And there will be papillary projections into cystic spaces, which is surrounded by lymphoid stroma and this stroma is mature Lymphoid follicles with germinal centers and the epithelium is always double-cell layered One is luminal cell and basal cell and then treatment part it is surgical Removal is option and it is not at all a recurrent type of lations So what in steamer is a second most common tumor affecting the salivary gland and it is exclusively on the parotid gland, which is Second common after the pleomorphic adenoma So that's all about what in steamer now. Let's move on to the brown tumor So brown tumor as I said it is related to para-thyroid glands. So we need to understand about Para-thyroid glands and its secretion Okay, so it is due to the excessive secretion of PTH para-thyroid hormone So there will be three courses like primary secondary and tertiary courses Pathology will be these para-thyroid glands are the two small paired endocrine glands So period and inferior on the posterior surface of thyroid gland It basically enhances the calcium level by stimulating tubular absorption or intestinal absorption and bone resorption So, how does it affect on the skeletal system? So there will be if PTH increased there will be general loss of bone substances the osteoclastic hyperactivity produces subperiosteal erosions and endosteal Cavitation and replacement of the marrow space by vascular granulation sand fibrous tissue that is known as austritis fibrosa cystica But our concern is brown tumor brown tumor is nothing but the hemorrhage and giant cell reaction Within the fibrous trauma which give rise to a brownish tumor like masses Whose liquefaction leads to a fluid filled cyst that is brown tumor So what happens is hemorrhage and giant cell reaction? Within the fibrous trauma which give rise to brownish tumor like masses Whose liquefaction leads to fluid filled cyst which is known as brown tumor So brown tumor is basically a non your plastic Condition and it is often misdiagnosed as a metastatic because of its radiographic appearances So basic symptoms and sign is as I said it is related to hypercalcemia There'll be anorexia, nausea, abdominal pain and depressions, fatigue and muscle weakness Renal presentations, there'll be polyurea, stones that is nephrocalsinosis Skeletal and bone there'll be joint symptoms that is controcalsinosis Because of this high osteoclastic activity The brown tumor is happening because as I said The hemorrhage and giant cell reaction which leads to tumor like masses The radiographic features there'll be single or multiple well-defined lesions affecting most commonly maxillin mandible that is facial bonds or even pelvis, ribs and femoral bone So on treatment what happens is there'll be healing with increased radio density So it appears with increased radio density people who are undergoing treatment And there'll be osteoporosis and areas of cortical erosion because of this high osteoclastic activity So the classical pathognomic feature is subperiosteal cortical resorption of middle phalanges, so that is a classical feature of Brown tumor there'll be subperiosteal cortical resorption So why it is getting this brown color because of this hemociderin deposition into this osteolytic cyst So hemociderin deposition is the cause of this brown tumor that is why it got that name because of this color because of this hemociderin deposition So how do we treat this brown tumor? Brown tumor can be treated by Parathyroidctomy or we can give calcitriol medication. So it's a Problem associated with parathyroid gland we can go for a parathyroidctomy and clear the problem So that is about brown tumor it is related to parathyroid gland and the classical feature is subperiosteal cortical resorption and the brown color is due to hemociderin pigment and It is also a non-neoplastic condition just like what in steamer So we are covered what in steamer and brown tumor what in steamer is nothing but the Second most common tumor in the salivary gland and exclusively on the parathyroid gland So I'll come up with new session and dentistry and oral pathology. Thank you