Furthermore, brown tumors, especially when manifested on facial bones, can be misdiagnosed as cancerous. Radiographs distinctly show bone resorption and X-rays of the skull may depict an image often described as "ground glass" or "salt and pepper". Dental X-rays may also be abnormal. Cysts may be lined by osteoclasts and sometimes blood pigments, which lend to the notion of "brown tumors." Such cysts can be identified with nuclear imaging combined with specific tracers, such as sestamibi. Identification of muscular degeneration or lack of reflex can occur through clinical testing of deep tendon reflexes, or via photomotogram (an achilles tendon reflex test).Fine needle aspiration (FNA) can be used to biopsy bone lesions, once found on an X-ray or other scan. Such tests can be vital in diagnosis and can also prevent unnecessary treatment and invasive surgery. Conversely, FNA biopsy of tumors of the parathyroid gland is not recommended for diagnosing parathyroid carcinoma and may in fact be harmful, as the needle can puncture the tumor, leading to dissemination and the possible spread of cancerous cells.The brown tumors commonly associated with OFC display many of the same characteristics of osteoclasts. These cells are characteristically benign, feature a dense, granular cytoplasm, and a nucleus that tends to be ovular in shape, enclosing comparatively fine chromatin. Nucleoli also tend to be smaller than average. Management
Medical
Medical management of OFC consists of vitamin D treatment, generally alfacalcidol or calcitriol, delivered intravenously.
Fuller Albright diagnosed and treated the woman, who had a large tumor of the neck as well as renal stones.The first published literature to describe a brown tumor (which was linked to OFC) was published in 1953, though clinical reports from before 1953 do draw a correlation between the disease and tumors previous to the publication.The advent of the multichannel autoanalyzer in the 1960s and 70s led to an increase in early diagnosis of primary hyperparathyroidism. This increase led to a sharp decline in the prolonged manifestation of the disease, leading to a drop in the number of cases of OFC due to the early detection of hyperparathyroidism. Before this invention, the diagnosis of primary hyperparathyroidism was generally prolonged until the emergence of severe manifestations, such as OFC. References
Bibliography
Campbell, Neil (1987). Biology. Menlo Park, Calif: Benjamin/Cummings Pub. Co. ISBN 978-0-8053-1840-1. Eberstein, Arthur; Goodgold, Joseph (1983). Electrodiagnosis of Neuromuscular Diseases. Baltimore: Williams & Wilkins. ISBN 978-0-683-03686-2. Ellis, Harold (2002). A History of Surgery. London: Greenwich Medical Media. p. 210. ISBN 978-1-84110-181-1. Hricik, Donald; R. Tyler Miller; John R. Sedor (2003). Nephrology Secrets. Hanley & Belfus. p. 175. ISBN 978-1-56053-502-7. Levine, Michael W.; Bilezikian, John P.; Marcus, Robert (2001). The Parathyroids: Basic and Clinical Concepts. Boston: Academic Press. ISBN 978-0-12-098651-4. Stevens, Arthur (1922). "The Practice of Medicine". W. B. Saunders Co. {{cite journal}}: Cite journal requires |journal= (help)
Patton, Kevin T.; Thibodeau, Gary A. (1996). Anthonys Textbook of Anatomy & Physiology. St. Louis: Mosby. ISBN 978-0-8151-8861-2. == External links ==