Since 1993, our 34-year-old female patient was on replacement treatment with hemodialysis for terminal renal failure due to hypertensive nephropathy. She developed severe secondary hyperparathyroidism. In 1996, she presented with a brown tumor, localized in the region of the left maxillary sinus and at its front. The patient did not take phosphate binders and treatment with vitamin D was not possible due to the increased Ca × P product. She had no difficulties, so she did not desire a surgical parathyroidectomy. As she had trouble breathing through the nose, and because of the facial deformity due to the brown tumor, she decided to have the tumor removed surgically.