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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Bump On Top Of Forehead Indicate Bone Cancer?

Hi - I saw my family doctor in October and showed him a small bump at the top of my forehead, where the hairline starts. He ordered an x-ray of my skull which showed density changes suggesting possible metabolic bone disease, and has ordered a bone densitrometry test and extensive bloodwork. He is ordering these as he thinks it could be that the parathyroid gland is overactive, and if that is the case, that would be removed. I asked him if there is any possibility of cancer, and he said possibly, but that he feels it is more related to the parathyroid gland. I asked him if I am diagnosed with cancer, what type of cancer could it be? He told me it would bone cancer. What are your thoughts?
Tue, 13 Jan 2015
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Pathologist and Microbiologist,  's  Response
Hello and welcome to HCM,
Overactive parathyroid glands lead to formation of brown tumor in the bones.
Brown tumor are formed due to over activity of bone forming cells.
'Brown tumor' is a misnomer since it is not a tumor and it is a manifestation of metabolic disturbance caused by hyperparathyroidism.
A couple of investigations are required before diagnosis can be made and management can be done.
An aspiration cytology of the swelling is required and this investigation can differentiate between a bone tumor and brown tumor caused by hyperthyroidism.
Thereafter, blood tests for calcium and parathormone also need to be done to assess the function of parathyroid gland.
In case these investigations suggest any abnormality of parathyroid gland, specialized scan for parathyroid will be required to assess whether there is enlargement of all parathyroid glands or enlargement of single parathyroid gland.
You need to consult an orthopedician for these investigations and thus further work up.

Thanks and take care
Dr Shailja Puri
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Could Bump On Top Of Forehead Indicate Bone Cancer?

Hello and welcome to HCM, Overactive parathyroid glands lead to formation of brown tumor in the bones. Brown tumor are formed due to over activity of bone forming cells. Brown tumor is a misnomer since it is not a tumor and it is a manifestation of metabolic disturbance caused by hyperparathyroidism. A couple of investigations are required before diagnosis can be made and management can be done. An aspiration cytology of the swelling is required and this investigation can differentiate between a bone tumor and brown tumor caused by hyperthyroidism. Thereafter, blood tests for calcium and parathormone also need to be done to assess the function of parathyroid gland. In case these investigations suggest any abnormality of parathyroid gland, specialized scan for parathyroid will be required to assess whether there is enlargement of all parathyroid glands or enlargement of single parathyroid gland. You need to consult an orthopedician for these investigations and thus further work up. Thanks and take care Dr Shailja Puri