Medical mumbo-jumbo – especially classification of anatomy, diseases and pathology – has roots going back several millennia to the Greek physician Hippocrates (circa 460 to 370 B.C.).
The Greek became Latinized (while retaining a fair amount of Greek), and Latin remains the official language of anatomic terminology and taxonomy. Latin is less susceptible to semantic drift and erosion, and it remains in use in medicine and other sciences.
Common examples are: lipoma, a benign tumor of adipose (fat) cells; osteoma, a benign tumor of bone; neuroma, any tumor derived of the nervous system; carcinomas, malignant tumors of many cell types and body sites; and epitheliomas, skin tumors.
There are hundreds, perhaps thousands, of “omas,” the Greek suffix that denotes tumor or neoplasm. However, usage of “oma” has been corrupted in the past few decades.
One example is “fascinoma,” which is not even remotely a classic “oma.” Fascinomas are semantic drift on a huge scale. Quite simply, “fascinoma” is medical slang for a fascinating and/or rare case, disease or condition. One illustrative case, published in a prominent medical journal, is memorable.
A youngish male had the misfortune to have a six-penny nail embedded within his skull, i.e., in his brain. He had some residual neurological deficit, which could usually be detected in a brief neurological exam. His situation was aggravated by a proclivity to drink, rendering him at high risk for subsequent trauma, particularly falls.
Thus, he was frequently scooped up by the emergency folks and transported to a multiplicity of urban emergency rooms. With sodden cerebral function rendering a medical history unobtainable, he probably set a record for skull X-rays, head CTs and consultations. Many, many people witnessed that nail. Sobering to consciousness, he would sign out only to repeat the scenario – a fascinoma.
A recent usage of “oma” has appeared: the “incidentaloma.” An incidentaloma is a lump, cyst, nodule or a “something” that is incidentally noted on an ultrasound, X-ray, CT, MRI or other advanced imaging modality. Incidentalomas can appear almost anywhere. A dilemma often centers over whether the something, the incidentaloma, is a threat – a tumor or not.
The America College of Radiology has studied this problem and published guidelines as to what can be dismissed and what should be investigated. Repeat studies entail additional expense and often more radiation. Families may be reluctant to “wait and see,” while biopsies add another layer of risk and expense.
An old, hard-rock miner I knew had an incidentaloma near his trachea, which was detected on a chest X-ray. A surgeon recommended that it be left alone. His family was not satisfied. A second surgeon biopsied it with immediate results. The “something” was a blood vessel. My friend bled out on the table – not pretty.
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.