Musculoskeletal imaging: management of a brown tumour: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Musculoskeletal imaging: management of a brown tumour

Sample item

A 40-year-old woman has bone pain and a lytic expansile lesion in the mandible with giant cells on biopsy. Serum calcium and PTH are high. What is the correct approach to the lesion?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Treat the hyperparathyroidism, since brown tumours regress after parathyroidectomy

Brown tumours are osteoclastic lytic lesions of hyperparathyroidism and often regress after the parathyroid disorder is corrected. They can be mistaken for giant cell tumours or metastases, so PTH and calcium help to resolve the diagnosis. Aggressive local treatment is unnecessary.

Option by option

  • A. Denosumab as the only treatment

    Denosumab would not address the cause and is not the standard approach.

  • B. High-dose radiotherapy

    Radiotherapy has no role and is unnecessary.

  • C. Treat the hyperparathyroidism, since brown tumours regress after parathyroidectomy (correct)

    Correct. Correcting hyperparathyroidism leads to regression.

  • D. Wide en bloc resection of the mandible

    Radical resection is not needed for a metabolic lesion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Treat the hyperparathyroidism, since brown tumours regress after parathyroidectomy. Brown tumours are osteoclastic lytic lesions of hyperparathyroidism and often regress after the parathyroid disorder is corrected.

Why is "Denosumab as the only treatment" not the answer?

Denosumab would not address the cause and is not the standard approach.

Why is "High-dose radiotherapy" not the answer?

Radiotherapy has no role and is unnecessary.

Why is "Wide en bloc resection of the mandible" not the answer?

Radical resection is not needed for a metabolic lesion.

What concept does this question test?

It tests Musculoskeletal imaging: management of a brown tumour in Radiology. They can be mistaken for giant cell tumours or metastases, so PTH and calcium help to resolve the diagnosis. Aggressive local treatment is unnecessary.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Musculoskeletal imaging: management of a brown tumour?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.