99m Tc-Octreotide-Avid Brain Mass In A Patient With Poorly Differentiated Papillary Thyroid Carcinoma, Hope In Despair.

Brain metastases of PTC are rare and occur in 0.1-5% of the patients, especially in the poorly differentiated types that usually fail to concentrate iodine. We present a rare case of PTC with probable brain metastasis in a 58-year-old woman with a history of poorly differentiated PTC that showed elevated Tg levels and no metastasis was detected in the whole-body iodine scan, despite the positive 99m Tc-octreotide scintigraphy. This imaging modality could be helpful as a diagnostic guide for radionuclide therapy with labeled somatostatin analogs in cases of thyroid carcinoma with elevated Tg levels and negative whole-body iodine scan.

Multiple photopenic vertebrae in the bone scintigraphy of a young man with Gorham disease: CT and MRI correlation.

We report a rare pattern of extensive bone abnormalities on the Tc-99m MDP bone scintigraphy in a patient with Gorham disease. This rare condition is the result of vascular and lymphatic channel proliferation in bony structures which induce bone resorption. Our case is a 28-year-old man with a history of biopsy-proven soft tissue hemangioma in the left thigh, encountered with a recent diagnosis of multiple vertebral hemangiomata in the axial skeleton and progressive bony destructions in the pelvis on CT and MRI images, referred for bone scintigraphy. Multiple photopenic hemangiomata were noted on bone scan.

The role of "after washing imaging" in evaluation of tear drainage system by dacryoscintigraphy.

BACKGROUND: The aim of this study was to evaluate the efficacy of "after washing" imaging in interpretation of dacryoscintigraphy as a functional imaging technique used in evaluation of tearing problems. MATERIALS AND METHODS: 300 nasolacrimal systems were studied. 100 µCi of technetium-99m sodium pertechnetate as drops of activity (10 µL) were placed into the inferior fornix of each eye. Dynamic images were obtained for 15 minutes in the sitting position. "After washing" phase was done by placing a drop (10 µL) of normal saline in each eye and external ocular massage for an additional 10 minutes. The imaging patterns for each eye in the first dynamic phase and after washing phase were recorded, separately. RESULTS: First dynamic phase demonstrated a sensitivity of 97.4% and specificity of 22.6%. After washing phase showed a sensitivity of 91.2% and specificity 75.5%. After washing test, the obstruction pattern changed to "patent nasolacrimal duct" or "further progression" of the radiotracer to the nasolacrimal duct in the 25.1% and 24.4% of the nasolacrimal systems, respectively. CONCLUSIONS: After washing imaging is a useful method in dacryoscintigraphy which can improve the specificity of scan for diagnosis of lacrimal duct obstruction. It can also improve the localization of obstruction level in the lacrimal systems.

Head and Neck Cancers in North-East Iran: A 25 year Survey.

INTRODUCTION: Cancers are among the worst noncommunicable diseases around the world. Head and neck cancers are ranked as the fifth most common cancers worldwide. As there are different distributions of risk factors around the world, the incidence of these cancers varies from one place to another. MATERIALS AND METHODS: We conducted a descriptive analytic cross-sectional study, based on census-based records from the private oncology clinic in Mashhad, Iran. Data from 1,075 patients with head and neck cancers were analyzed from 1986 to 2010. We categorized the duration of study into five periods: 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2010. Head and neck cancers refers to cancers originating from seven sites in the head and neck including the nasal cavity, oral cavity, pharynx, larynx, salivary glands, paranasal sinuses, and thyroid. RESULTS: Data of 1,075 patients were analyzed. 66.2% were male. Mean ± standard deviation (SD) age at the time of diagnosis was 55.37±15.55 years. The most frequent type of head and neck cancer was larynx cancer (36%), followed by pharynx (28.5%), oral (17.5%), thyroid (6.8%), sinus (6.4%), salivary gland (4.10%), and nasal cancer (0.70%). although larynx cancer was the most frequent cancer over the whole study duration, there was a significant (P=0.04) difference in the relative frequency of these cancers across the five time periods. There was a significant difference in mean age between cancer categories (P<0.001). The only cancer with a different mean age at different time periods was pharynx cancer (P=0.02). There was a significant difference between sex and cancer categories (P<0.001). CONCLUSION: Laryngeal cancer was the most common head and neck cancer over the whole duration of this study. The differences in the patterns of other head and neck cancers could be due to geographical differences and also different risk factors and lifestyles all over the world. Further investigations in these fields are suggested in future studies.

Radiotracer Injection Into the Catheter Balloon: A Subtle Pitfall Which Can Be Overlooked in Direct Radionuclide Cystography.

We reported a 4-year-old girl with history of bilateral vesicoureteral reflux who underwent direct radionuclide cystography in our department. Radiotracer was mistakenly injected in the catheter balloon. The filling phase showed no change in the bladder volume, and the catheter balloon was apparent as an intense activity in the base of the bladder. The procedure was repeated with correct injection of the tracer into the catheter. Wrong injection of the radiotracer into the catheter balloon should always be borne in mind in similar cases.

99mTc-Labeled Ubiquicidin Accumulation in a Retained Surgical Gauze.

A 31-year-old woman underwent Tc-labeled UBI scanning for diagnosis of possible prosthesis infection evaluation in our department. The scan showed an area of increased tracer uptake in the mid-lateral portion of the left thigh. This was proven to be due to a retained surgical gauze in her left thigh.

Demographic survey of four thousand patients with 10 common cancers in North Eastern Iran over the past three decades.

BACKGROUND: Cancer is a major cause of mortality in developing countries and correct and valid information about the epidemiology of this disease is the first step in the planning of health care in each region. The aim of this study was to determine the relative frequency, mean age and sex ratio of the most 10 common non-skin cancers in the world and Iran, among patients referred to an oncology clinic. MATERIALS AND METHODS: This descriptive study was conducted in Mashhad, north east of Iran. The data obtained from the records of patients referred to the private oncology center between the years of 1985-2012." According to the latest report of GLOBOCAN study commonest malignancies included were lung, breast, colorectal, prostate, stomach, liver, cervix, esophageal, bladder cancers and Non-Hodgkin lymphoma. RESULTS: A total of 4,606 cases were analyzed. The mean age was 55.5±13.8years (male: 59.5±13.9, female: 52.6±12.9). Overall, breast cancer (1,264 cases, relative frequency of 27.4%) was the most prevalent cancer; however the mean ages of diagnosis were not significantly different between 5-year time period divisions (p=0.290). The most common cancer in men was esophageal cancer (26.3%).The lowest mean age was related to women diagnosed with breast cancer (48.5±11.8) and men with non-Hodgkins lymphoma (48.4±17.8). There were statistically significant differences between the mean age of men and women with gastric (p=0.003) and esophageal cancers (p<0.001). Male to female sex ratios in our study for bladder, lung and stomach cancers were 6.57, 2.60 and 2.50 respectively. CONCLUSIONS: The results showed that breast cancer tends to be found in younger female patients and bladder cancer appears more often in men. Screening in target population in addition to early diagnosis may reduce death and disability.