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Presumed osteosarcoma.

Kettritz R, Mohebbi N, Claus T, Kettritz U, Schneider W, Luft FC - Clin Kidney J (2013)

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A 76-year-old dialysis patient developed sudden pain in his left arm... Mourad et al. described a mandibular brown tumour in a dialysis patient who responded to intravenous alfacalcidol... We elected to treat our patient with cinacalcet... As a result, the parathyroid hormone concentration decreased from 286 to 83, 68 and 62 pg/mL over a 4-week period, respectively... The efficacy of cinacalcet in secondary hyperparathyroidism is convincing... Conceivably, our patient needed a parathyroidectomy, a procedure shown to be effective in dialysis patients with a maxillary brown tumour... The lesson here is the strong histological similarity between brown and malignant tumours... First, hyperparathyroidism does not ‘protect’ from osteosarcoma, and several convincing examples of both diagnoses are present in the literature... Bone tumours in dialysis patients are brown tumours until proven otherwise... Colleagues outside our specialty need to be alerted to brown tumours in patients with renal failure... None declared.

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Roentgenogram of the left shoulder shows a destructive process immediately below the humeral head. The cortical bone is disrupted suggesting a malignant process.
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SFT040F1: Roentgenogram of the left shoulder shows a destructive process immediately below the humeral head. The cortical bone is disrupted suggesting a malignant process.

Mentions: A 76-year-old dialysis patient developed sudden pain in his left arm. He consulted an orthopaedic surgeon who determined a fractured left humerus with an osteolytic lesion (Figure 1). The patient was referred to our department for further evaluation of a possible osteoscarcoma. He had required haemodialysis treatment for 4 years because of an unknown renal disease that left him with small end-stage kidneys. The patient had come to Germany from Russia, spoke only Russian and was relatively non-adherent to his dialysis treatments and medications. The physical examination revealed a systolic murmur, a functioning dialysis access, a painful immobilized left arm, but no other musculoskeletal lesions. Pertinent laboratory findings included some residual renal function, serum creatinine 345 ┬Ámol/L, calcium 2.78 mmol/L, phosphate 1.41 mmol/L, C-reactive protein 99 mg/L and parathyroid hormone 286 pg/mL.Fig. 1.


Presumed osteosarcoma.

Kettritz R, Mohebbi N, Claus T, Kettritz U, Schneider W, Luft FC - Clin Kidney J (2013)

Roentgenogram of the left shoulder shows a destructive process immediately below the humeral head. The cortical bone is disrupted suggesting a malignant process.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400485&req=5

SFT040F1: Roentgenogram of the left shoulder shows a destructive process immediately below the humeral head. The cortical bone is disrupted suggesting a malignant process.
Mentions: A 76-year-old dialysis patient developed sudden pain in his left arm. He consulted an orthopaedic surgeon who determined a fractured left humerus with an osteolytic lesion (Figure 1). The patient was referred to our department for further evaluation of a possible osteoscarcoma. He had required haemodialysis treatment for 4 years because of an unknown renal disease that left him with small end-stage kidneys. The patient had come to Germany from Russia, spoke only Russian and was relatively non-adherent to his dialysis treatments and medications. The physical examination revealed a systolic murmur, a functioning dialysis access, a painful immobilized left arm, but no other musculoskeletal lesions. Pertinent laboratory findings included some residual renal function, serum creatinine 345 ┬Ámol/L, calcium 2.78 mmol/L, phosphate 1.41 mmol/L, C-reactive protein 99 mg/L and parathyroid hormone 286 pg/mL.Fig. 1.

View Article: PubMed Central - PubMed

Affiliation: ;

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

A 76-year-old dialysis patient developed sudden pain in his left arm... Mourad et al. described a mandibular brown tumour in a dialysis patient who responded to intravenous alfacalcidol... We elected to treat our patient with cinacalcet... As a result, the parathyroid hormone concentration decreased from 286 to 83, 68 and 62 pg/mL over a 4-week period, respectively... The efficacy of cinacalcet in secondary hyperparathyroidism is convincing... Conceivably, our patient needed a parathyroidectomy, a procedure shown to be effective in dialysis patients with a maxillary brown tumour... The lesson here is the strong histological similarity between brown and malignant tumours... First, hyperparathyroidism does not ‘protect’ from osteosarcoma, and several convincing examples of both diagnoses are present in the literature... Bone tumours in dialysis patients are brown tumours until proven otherwise... Colleagues outside our specialty need to be alerted to brown tumours in patients with renal failure... None declared.

No MeSH data available.


Related in: MedlinePlus