Uremic Leontiasis Ossea: A Rare Craniofacial Manifestation of Secondary Hyperparathyroidism -A Case Report

Uremic leontiasis ossea (ULO) is the rare, severe manifestation of renal osteodystrophy, a component of chronic kidney disease–mineral and bone disorder (CKD-MBD), characterized by progressive overgrowth of the craniofacial bones due to secondary hyperparathyroidism. Clinical features include jaw enlargement, widening of the nares, flattening of the nasal bridge, and increased spacing between the teeth. Along with these typical clinical features, this condition has distinctive imaging features, that is, internal serpiginous tunnelling. Beyond cosmetic impairment, patients often suffer from functional impairment like dyspnea, dysphagia, and cranial nerve compromise. Early recognition of this condition by specific imaging features and prompt management is essential to avoid devastating complications. This report describes a 15-year-old male with features of ULO, emphasizing the clinical presentation, laboratory findings, and imaging features of this rare entity.