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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.

No MeSH data available.


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MRI of shoulder region showing a soft tissue tumour with remarkably low signal intensity in T1-weighted spin-echo MRI.
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SFT040F2: MRI of shoulder region showing a soft tissue tumour with remarkably low signal intensity in T1-weighted spin-echo MRI.

Mentions: We consulted our orthopaedic surgeons who were convinced that the patient had a malignant tumour. They requested a magnetic resonance imaging scan (Figure 2) and suggested a wide excision with insertion of a humoral head prosthesis. We obtained a bone scan (not shown) that was interpreted as showing a lesion in the humeral head, as well as probable metastases in the left distal femur and left mid-tibial shaft and skull. We negotiated a compromise and agreed to settle on a biopsy of the humeral lesion together with plate fixation to stabilize the humerus. Before we transferred the patient to surgery, we performed a 99mTc-MIBI parathyroid gland scintigraphy. That study raised the possibility of a parathyroid adenoma. The surgeons performed, as promised, a limited biopsy of the humeral lesion. We had alerted the pathology department of our suspicion. The pathologist claimed that had he not known the patient's prior medical history, he would have diagnosed a malignant bone tumour on the basis of the frozen section.Fig. 2.


Presumed osteosarcoma.

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

MRI of shoulder region showing a soft tissue tumour with remarkably low signal intensity in T1-weighted spin-echo MRI.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

SFT040F2: MRI of shoulder region showing a soft tissue tumour with remarkably low signal intensity in T1-weighted spin-echo MRI.
Mentions: We consulted our orthopaedic surgeons who were convinced that the patient had a malignant tumour. They requested a magnetic resonance imaging scan (Figure 2) and suggested a wide excision with insertion of a humoral head prosthesis. We obtained a bone scan (not shown) that was interpreted as showing a lesion in the humeral head, as well as probable metastases in the left distal femur and left mid-tibial shaft and skull. We negotiated a compromise and agreed to settle on a biopsy of the humeral lesion together with plate fixation to stabilize the humerus. Before we transferred the patient to surgery, we performed a 99mTc-MIBI parathyroid gland scintigraphy. That study raised the possibility of a parathyroid adenoma. The surgeons performed, as promised, a limited biopsy of the humeral lesion. We had alerted the pathology department of our suspicion. The pathologist claimed that had he not known the patient's prior medical history, he would have diagnosed a malignant bone tumour on the basis of the frozen section.Fig. 2.

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