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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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(A) Lacunar bone reabsorption with intense osteitis (Goldner trichrome stain). (B) Brown tumour with numerous multinucleated osteoclastic giant cells (H&E stain). (C) Brown tumour, giant cells and numerous haemosiderin-laden macrophages with their brown pigmentation (H&E stain). (D) Reactive bone formation within a brown tumour. Visible is a wide osteoid seam of osteoblasts; the bone appears red (Goldner trichrome stain).
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SFT040F3: (A) Lacunar bone reabsorption with intense osteitis (Goldner trichrome stain). (B) Brown tumour with numerous multinucleated osteoclastic giant cells (H&E stain). (C) Brown tumour, giant cells and numerous haemosiderin-laden macrophages with their brown pigmentation (H&E stain). (D) Reactive bone formation within a brown tumour. Visible is a wide osteoid seam of osteoblasts; the bone appears red (Goldner trichrome stain).

Mentions: 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 [5]. Secondly, (Figure 3A–D) the differential diagnosis is by no means trivial. Osteoclast-like giant cells may dominate the histologic pattern not only in conventional giant-cell tumours, but also in many tumour-like lesions of bone. The pathologist is greatly assisted by clinical information in such patients. If the pathologist knows that the patient has (primary or secondary) hyperparathyroidism, the diagnostic possibilities are limited accordingly. Finally, we wish to draw attention to the occurrence of an osteosarcoma in the maxilla of a brown bear (Ursus arctos), presumably another form of brown tumour [6]. We believe that this finding gives an entirely different dimension to the diagnostic ramifications of brown tumours.Fig. 3.


Presumed osteosarcoma.

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

(A) Lacunar bone reabsorption with intense osteitis (Goldner trichrome stain). (B) Brown tumour with numerous multinucleated osteoclastic giant cells (H&E stain). (C) Brown tumour, giant cells and numerous haemosiderin-laden macrophages with their brown pigmentation (H&E stain). (D) Reactive bone formation within a brown tumour. Visible is a wide osteoid seam of osteoblasts; the bone appears red (Goldner trichrome stain).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

SFT040F3: (A) Lacunar bone reabsorption with intense osteitis (Goldner trichrome stain). (B) Brown tumour with numerous multinucleated osteoclastic giant cells (H&E stain). (C) Brown tumour, giant cells and numerous haemosiderin-laden macrophages with their brown pigmentation (H&E stain). (D) Reactive bone formation within a brown tumour. Visible is a wide osteoid seam of osteoblasts; the bone appears red (Goldner trichrome stain).
Mentions: 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 [5]. Secondly, (Figure 3A–D) the differential diagnosis is by no means trivial. Osteoclast-like giant cells may dominate the histologic pattern not only in conventional giant-cell tumours, but also in many tumour-like lesions of bone. The pathologist is greatly assisted by clinical information in such patients. If the pathologist knows that the patient has (primary or secondary) hyperparathyroidism, the diagnostic possibilities are limited accordingly. Finally, we wish to draw attention to the occurrence of an osteosarcoma in the maxilla of a brown bear (Ursus arctos), presumably another form of brown tumour [6]. We believe that this finding gives an entirely different dimension to the diagnostic ramifications of brown tumours.Fig. 3.

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