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ABSTRACT: A 59-year-old woman with recent history of weakness, loss of appetite, and significant weight loss was referred for malignancy workup. On the first day, the patient underwent a 99mTc-MDP scan, which revealed diffuse pulmonary uptake in both lungs. Two days later, 99mTc-FAPI scan was performed and showed diffuse pulmonary uptake in the planar and SPECT/CT images. The study present an interesting case demonstrating FAPI-ligand uptake in metastatic pulmonary calcification.
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Calcinosis , Medronato de Tecnecio Tc 99m , Humanos , Femenino , Persona de Mediana Edad , Medronato de Tecnecio Tc 99m/análogos & derivados , Calcinosis/diagnóstico por imagen , Compuestos de Organotecnecio , Huesos/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
CONTEXT: A major indication for referrals for bone scans (BS) to establish or exclude skeletal metastases. Few patients are referred with clinically indeterminate diagnosis or cancer of unknown primary (CUP), to search for bony metastases or primary tumor. AIMS: This study aimed to assess the usefulness or otherwise for BS in such instances. SETTINGS AND DESIGN: A retrospective cross-sectional study of BS performed for CUP and indeterminate diagnosis from 2012 to 2016 in the nuclear medicine unit of a tertiary teaching hospital. SUBJECTS AND METHODS: The study involved reviews of technetium-99m diphosphonate BS for patients with CUP. BSs were reported by nuclear physicians as normal, normal variants, suspicious for metastases or as malignant, and with solitary or multiple skeletal metastases. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS version 21 for descriptive analysis. Continuous data were displayed as means along with their standard deviation; categorical data were tabulated as frequencies and percentages. RESULTS: Of 2156 BS, 42 (0.02%) were eligible. Patients were aged 27-86 years, mainly in the sixth and seventh decades of life. Bone metastases were identified in 14 (33%) of these patients, whereas 17 BS (40%) were normal, BS appeared equivocal in 10 (23.8%). CONCLUSIONS: Single-photon emission computed tomography/computed tomography availability would resolve the clinical dilemma in patients with equivocal and apparently normal BS.
Résumé Contexte:Une indication majeure pour les références à des scintigraphies osseuses (BS) pour établir ou exclure des métastases squelettiques. Peu de patients sont référés avec diagnostic cliniquement indéterminé ou cancer primitif inconnu (CUP), pour rechercher des métastases osseuses ou une tumeur primitive.Objectifs:Cette étude visait à évaluer l'utilité ou non de la BS dans de tels cas.Paramètres et conception:Une étude transversale rétrospective sur le BS réalisée pour CUP et diagnostic indéterminé de 2012 à 2016 dans l'unité de médecine nucléaire d'un hôpital universitaire tertiaire.Sujets et Méthodes:L'étude comprenait des examens du diphosphonate de technétium-99m BS pour les patients atteints de CUP. Des BS ont été signalés par des médecins nucléaires comme normales, variantes normales, suspectes de métastases ou malignes, et avec métastases squelettiques solitaires ou multiples.Analyses statistiques utilisé:Les données ont été analysées à l'aide de SPSS version 21 pour une analyse descriptive. Les données continues ont été affichées comme moyennes avec leur l'ecarts t; les données catégorielles ont été présentées sous forme de fréquences et de pourcentages.Résultats:Sur 2156 BS, 42 (0,02%) étaient éligibles. Les patients étaient âgés 27 à 86 ans, principalement dans les sixième et septième décennies de la vie. Des métastases osseuses ont été identifiées chez 14 (33 %) de ces patients, alors que 17 BS (40 %) étaient normaux, la BS semblait équivoque dans 10 cas (23,8 %).Conclusions:Tomodensitométrie par émission de photons uniques/tomodensitométrie la disponibilité résoudrait le dilemme clinique chez les patients atteints de BS équivoque et apparemment normale.
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Neoplasias Óseas , Humanos , Femenino , Masculino , Neoplasias Óseas/secundario , Neoplasias Óseas/diagnóstico por imagen , Persona de Mediana Edad , Estudios Transversales , Estudios Retrospectivos , Anciano , Adulto , Anciano de 80 o más Años , Neoplasias Primarias Desconocidas/diagnóstico por imagen , Neoplasias Primarias Desconocidas/patología , Cintigrafía , Radiofármacos , Huesos/diagnóstico por imagen , Huesos/patología , Medronato de Tecnecio Tc 99mRESUMEN
Aim: Nano-hydroxyapatite (nHA) is a good nanocarrier to load 223Ra, but the low specific activity (sp.act.) of 223Ra@nHA limits its application in medicine. Methods: We proposed a method for preparing nHA using PEG as a template, which significantly increases the sp.act of 223Ra@nHA and a new method to loaded 99mTc for in vivo tracking. Results: The nHA synthesized using PEG as a template was associated with higher sp.act for 223Ra in comparison to nHA with identical particle size and without PEG. The nHA load 99mTc-MDP was associated with higher labeling rate and stability in comparison to 99mTc. Conclusion: All these findings suggest that using PEG as a template and 99mTc-MDP could be the most effective of synthetic 223Ra/99mTc@nHA.
[Box: see text].
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Neoplasias Óseas , Durapatita , Tamaño de la Partícula , Radio (Elemento) , Durapatita/química , Humanos , Neoplasias Óseas/tratamiento farmacológico , Neoplasias Óseas/diagnóstico por imagen , Radio (Elemento)/química , Polietilenglicoles/química , Nanopartículas/química , Tecnecio/química , Línea Celular Tumoral , Radiofármacos/química , Animales , Medronato de Tecnecio Tc 99m/químicaRESUMEN
Extravasation of 99mTc-labeled radiopharmaceuticals is generally considered to require no specific intervention. In the presented case, the use of hyaluronidase could have minimized the adverse effects resulting from such an extravasation. Currently, no guidelines exist regarding the use of hyaluronidase after extravasation of [99mTc]Tc-HDP. Considering the low risk of administering hyaluronidase, it should be considered to limit the risk of injury after extravasation of [99mTc]Tc-HDP.
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Extravasación de Materiales Terapéuticos y Diagnósticos , Hialuronoglucosaminidasa , Radiofármacos , Humanos , Extravasación de Materiales Terapéuticos y Diagnósticos/diagnóstico por imagen , Compuestos de Organotecnecio/administración & dosificación , Radiofármacos/administración & dosificación , Medronato de Tecnecio Tc 99m/análogos & derivadosRESUMEN
Skeletal-related events due to bone metastases can be prevented by early diagnosis using radiological or nuclear imaging techniques. Nuclear medicine techniques such as Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) have been used for diagnostic imaging of bone for decades. Although it is widely recognized that conventional diagnostic imaging techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) have high sensitivity, low cost and wide availability, the specificity of both techniques is rather low compared to nuclear medicine techniques. Nuclear medicine techniques, on the other hand, have improved specificity when introduced as a hybrid imaging modality, as they can combine physiological and anatomical information. Two main radiopharmaceuticals are used in nuclear medicine: [99mTc]-methyl diphosphonate ([99mTc]Tc-MDP) from the generator and [18F]sodium fluoride ([18F]NaF) from the cyclotron. The former is used in SPECT imaging, while the latter is used in PET imaging. However, recent studies show that the role of radiolabeled bisphosphonates with gallium-68 (68Ga) and fluorine-18 (18F) may have a potential role in the future. This review, therefore, presents and discusses the brief method for producing current and future potential radiopharmaceuticals for bone metastases.
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Neoplasias Óseas , Difosfonatos , Tomografía de Emisión de Positrones , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único , Humanos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía de Emisión de Positrones/métodos , Neoplasias Óseas/secundario , Neoplasias Óseas/diagnóstico por imagen , Huesos/diagnóstico por imagen , Radioisótopos de Galio , Medronato de Tecnecio Tc 99mRESUMEN
ABSTRACT: A 53-year-old man with newly diagnosed nasopharyngeal carcinoma (NPC) underwent 99m Tc-MDP bone scintigraphy for the potential bone metastases, and paired 68 Ga-DOTATATE and 68 Ga-FAPI PET/CT for initial staging. 68 Ga-DOTATATE PET/CT identified 2 abnormal foci with increased tracer uptake in the cervical vertebra and the ilium, whereas 68 Ga-FAPI PET/CT and bone scan detected only the ilium lesion. A subsequent biopsy confirmed NPC metastasis in the ilium. Furthermore, baseline and follow-up bone scintigraphy revealed that the positive lesion in the cervical vertebra, as indicated in 68 Ga-DOTATATE PET/CT, was also a bone metastasis. This case highlighted the potential superiority of 68 Ga-DOTATATE in NPC.
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Neoplasias Óseas , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Compuestos Organometálicos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Medronato de Tecnecio Tc 99m , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo/diagnóstico por imagen , Carcinoma Nasofaríngeo/patología , Neoplasias Nasofaríngeas/diagnóstico por imagen , Neoplasias Nasofaríngeas/patología , Neoplasias Óseas/secundario , Neoplasias Óseas/diagnóstico por imagen , Radioisótopos de Galio , Carcinoma/diagnóstico por imagen , Carcinoma/secundarioRESUMEN
BACKGROUND: Data regarding the lesion detection ability of different radiotracers are lacking in equine bone scintigraphy. METHODS: In this prospective study, hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) were compared in horses with increased radiopharmaceutical uptake either in the caudal cervical region (CS group) or in the proximal metacarpal/metatarsal region (PMR group). Region of interest analysis was used to determine normal bone-to-soft tissue ratios, lesion-to-normal bone ratios and lesion-to-soft tissue ratios. Qualitative scoring and total count rates were recorded for each image. RESULTS: A total of 213 scintigrams were included. Within the PMR group, there were significantly higher lesion-to-normal bone ratios for MDP compared with HMDP (p = 0.02). In the CS group, normal bone-to-soft tissue ratios were significantly higher for HMDP (p = 0.01). The interobserver agreement with regard to the qualitative assessment of the scintigrams was poor. LIMITATION: Paired studies, comparing the different radiotracers in the same patient, were not feasible. CONCLUSION: This study revealed minor differences between the two radiotracers, although these have no practical implications. Both radiopharmaceuticals are well suited for detecting lesions at the investigated sites using equine bone scintigraphy.
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Huesos del Metacarpo , Huesos Metatarsianos , Animales , Caballos , Medronato de Tecnecio Tc 99m , Cintigrafía , Huesos del Metacarpo/diagnóstico por imagen , Estudios Prospectivos , Difosfonatos , RadiofármacosAsunto(s)
Adenocarcinoma , Neoplasias de los Músculos , Osificación Heterotópica , Neoplasias del Recto , Medronato de Tecnecio Tc 99m , Humanos , Neoplasias del Recto/patología , Neoplasias del Recto/diagnóstico por imagen , Adenocarcinoma/secundario , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/patología , Osificación Heterotópica/diagnóstico por imagen , Osificación Heterotópica/etiología , Osificación Heterotópica/patología , Neoplasias de los Músculos/secundario , Neoplasias de los Músculos/diagnóstico por imagen , Masculino , Cintigrafía , Músculo Esquelético/diagnóstico por imagen , Músculo Esquelético/patología , Hallazgos Incidentales , Radiofármacos , Persona de Mediana EdadRESUMEN
Objective: There is currently no non-invasive examination that can fully determine the diagnosis of osteomyelitis. SPECT/CT tomographic fusion imaging can provide both local metabolic activity and anatomical information to determine the condition and location. This study evaluates the diagnostic efficacy of 99mTc-MDP SPECT/CT in bone infections, compared to MRI. Methods: In this multicenter retrospective study, 363 patients with suspected bone and joint infections or osteomyelitis were included. Participants underwent 99mTc-MDP SPECT/CT and/or MRI examinations, supplemented by pathogenic bacterial cultures and histopathological analysis. Results: Only SPECT/CT was tested in 169 patients, and only MRI was used in 116. 78 people have implemented both inspections and have detailed information. The diagnostic sensitivity and specificity of SPECT/CT for infection were 96% and 92% respectively, with an accuracy of 96%. For MRI, these figures were 88%, 84%, and 87% respectively. Conclusion: This represents the largest global study to date evaluating osteomyelitis and bone infection diagnosis using 99mTc-MDP SPECT/CT tomographic fusion imaging. The findings indicate that 99mTc-MDP SPECT/CT fusion imaging offers superior diagnostic accuracy compared to MRI. This is particularly evident in cases involving metallic implants and chronic infections. 99mTc-MDP SPECT/CT fusion imaging emerges as a highly suitable non-invasive diagnostic modality, facilitating enhanced clinical follow-up and treatment.
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Difosfatos , Osteomielitis , Humanos , Estudios Retrospectivos , Medronato de Tecnecio Tc 99m , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada de Emisión de Fotón Único , Imagen por Resonancia Magnética , Osteomielitis/diagnóstico por imagenRESUMEN
OBJECTIVE: This study aimed to determine the prognostic value of the flare phenomenon in patients with metastatic castration-resistant prostate cancer (mCRPC) using the bone scan index (BSI) derived from 99mTc-methylenediphosphonate (MDP) bone scintigraphy images. METHODS: We categorized 72 patients from the PROSTAT-BSI registry with mCRPC who were followed-up for 2 years after starting docetaxel chemotherapy to groups based on pre-chemotherapy BSI values of < 1, 1-4, and > 4. We assessed the effects of the flare phenomenon (defined as a > 10% increase in the BSI within 3 months of starting chemotherapy, followed by > 10% improvement within the next 3 months) on survival using Kaplan-Meier curves and Cox proportional hazard analyses. RESULTS: The flare phenomenon was found in 26 (36%) of the 72 patients. Prostate-specific antigen (PSA), alkaline phosphatase (ALP), and hemoglobin (Hb) levels steadily increased, then deteriorated in patients with and without flare, respectively. Elevated BSI and PSA values at 3 months after starting therapy and the absence of abiraterone or/and enzalutamide therapy led to poor 2-year overall survival (OS) in the group without flare. In contrast, no influence was noticeable in the group with flare. The results of multivariable analyses that included only factors associated with PSA and BSI showed that increased baseline BSI (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.04-1.86; P = 0.023) and PSA (HR, 7.15; 95% CI 2.13-24.04; P = 0.0015) values could be independent risk factors for patients with mCRPC without flare. However, these factors lost significance during flare. The risk for all-cause death was significantly higher among patients with BSI > 4 without, than with flare. The results of univariable analyses indicated that flare positively impacted survival (HR, 0.24; 95% CI 0.06â0.91; P = 0.035). Multivariable analysis did not identify any factors that could predict outcomes. CONCLUSION: Favorable prognosis, with fewer disturbances from other factors such as the use of abiraterone or/and enzalutamide, PSA changes, and BSI, was attainable in cases when the mCRPC patient demonstrated flare phenomenon. Follow-up bone scintigraphy at least every 3 months could help to determine the prognosis of patients with bone metastasis of mCRPC.
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Neoplasias Óseas , Neoplasias de la Próstata Resistentes a la Castración , Cintigrafía , Humanos , Masculino , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Neoplasias de la Próstata Resistentes a la Castración/diagnóstico por imagen , Neoplasias de la Próstata Resistentes a la Castración/patología , Anciano , Pronóstico , Neoplasias Óseas/secundario , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/tratamiento farmacológico , Persona de Mediana Edad , Huesos/diagnóstico por imagen , Medronato de Tecnecio Tc 99m , Anciano de 80 o más Años , Antígeno Prostático Específico/sangreRESUMEN
PURPOSE: Neural network has widely been applied for medical classifications and disease diagnosis. This study employs deep learning to best discriminate Juvenile Idiopathic Arthritis (JIA), a pediatric chronic joint inflammatory disease, from healthy joints by exploring blood pool images of 2phase [ 99m Tc] Tc-MDP bone scintigraphy. METHODS: Self-deigned multi-input Convolutional Neural Network (CNN) in addition to three available pre-trained models including VGG16, ResNet50 and Xception are applied on 1304 blood pool images of 326 healthy and known JIA children and adolescents (aged 1-16). RESULTS: The self-designed model ROC analysis shows diagnostic efficiency with Area Under the Curve (AUC) 0.82 and 0.86 for knee and ankle joints, respectively. Among the three pertained models, VGG16 ROC analysis reveals AUC 0.76 and 0.81 for knee and ankle images, respectively. CONCLUSION: The self-designed model shows best performance on blood pool scintigraph diagnosis of patients with JIA. VGG16 was the most efficient model rather to other pre-trained networks. This study can pave the way of artificial intelligence (AI) application in nuclear medicine for the diagnosis of pediatric inflammatory disease.
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Artritis Juvenil , Medronato de Tecnecio Tc 99m , Adolescente , Humanos , Niño , Inteligencia Artificial , Artritis Juvenil/diagnóstico por imagen , Cintigrafía , Tecnecio , Aprendizaje AutomáticoRESUMEN
OBJECTIVE: To investigate the short-term efficacy and safety of Yunke (technetium-99 conjugated methylene diphosphonate) combined with pulsed electromagnetic field (PEMF) and Gukang capsule in the treatment of postmenopausal osteoporosis (PMOP). METHODS: A total of 112 patients with PMOP who received treatment in the Department of Nuclear Medicine of the hospital from January 2019 to June 2020 were selected and randomly divided into 4 groups of 28 patients each. Group A received Yunke and PEMFs, group B received Gukang capsules and PEMFs, group C received Yunke and Gukang capsules and PEMFs, and group D received PEMFs. All groups were given adequate amounts of calcium and active vitamin D. Intervention 2 sessions of 3 months each. Outcome measures were bone mineral density (BMD) and pain improvement. RESULTS: Compared with 1 course of treatment, the symptoms of bone pain were relieved more significantly after 2 courses of treatment in group A (50.0% vs. 64.3%), group B (46.4% vs. 64.3%), group C (78.6% vs. 92.9%) and group D (21.4% vs. 28.6%) (P < 0.05). After 2 courses of treatment, bone pain symptoms were less relieved in group A (96.4% vs. 64.3%), group B (96.4% vs. 64.3%), and group D (96.4% vs. 28.6%) compared with group C (P < 0.05). Compared with group C, BMD values of L4 vertebrae and femoral neck were significantly decreased in groups A, B, and D (P < 0.05). Compared with those before treatment, BMD of L4 vertebrae and femoral neck increased significantly in groups A, B, C, and D after 2 courses of treatment (P < 0.05). CONCLUSION: Yunke combined therapy can effectively relieve the pain symptoms, increase BMD, and reduce the risk of fracture in patients with PMOP in a short period, which is an effective method for the treatment of PMOP.
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Densidad Ósea , Osteoporosis Posmenopáusica , Humanos , Femenino , Osteoporosis Posmenopáusica/tratamiento farmacológico , Osteoporosis Posmenopáusica/diagnóstico por imagen , Persona de Mediana Edad , Densidad Ósea/efectos de los fármacos , Anciano , Medronato de Tecnecio Tc 99m , Conservadores de la Densidad Ósea/química , Radiofármacos/químicaRESUMEN
ABSTRACT: Desmoid fibromatosis, also called desmoid tumors, is a group of locally aggressive fibromatous proliferative disorders. They represent less than 3% of all soft tissue sarcoma and are multifocal in approximately 10% of cases. However, there are only a few cases in the literature describing 18F-FDG PET/CT and 99mTc-MDP bone scan features of extra-abdominal desmoid fibromas, and all were solitary bone lesions. Herein, we presented a unique case of multifocal desmoid fibromatosis of bone illustrating the prospective value of 18F-FDG PET/CT and 99mTc-MDP bone scan in the evaluation of desmoid tumors.
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Neoplasias Óseas , Fibroma , Fibromatosis Agresiva , Humanos , Medronato de Tecnecio Tc 99m , Fluorodesoxiglucosa F18 , Tomografía Computarizada por Tomografía de Emisión de Positrones , Fibromatosis Agresiva/diagnóstico por imagen , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Neoplasias Óseas/diagnóstico por imagenRESUMEN
ABSTRACT: Fibrous dysplasia (FD) typically presents unilaterally in the lower limbs, or in the skull, mandible, or pelvis. Bilateral presentation is rarely reported. Most cases are diagnosed in the teens with 75% of patients diagnosed before the age of 30 years. In this case, a 63-year-old woman with suspected diagnosis of malignancy was referred to 99mTc-MDP scan and found to have polyostotic FD in bilateral upper extremities. Nuclear medicine can play an important role in diagnosing FD cases with atypical presentation and help risk stratification for more aggressive transformation.
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Displasia Fibrosa Ósea , Displasia Fibrosa Poliostótica , Femenino , Humanos , Persona de Mediana Edad , Displasia Fibrosa Poliostótica/diagnóstico por imagen , Cintigrafía , Cráneo , Medronato de Tecnecio Tc 99mRESUMEN
Se presenta el caso de un paciente con antecedente de adenocarcinoma de próstata y diagnóstico de ACV isquémico con transformación hemorrágica. La gammagrafía ósea con Tc-99m MDP complementada con SPECT e imágenes de fusión con TC cerebral simple, realizada a los 15 días, muestra hipercaptación en la región temporal izquierda, correspondiente al ACV en etapa subaguda.
We present the case of a patient with a history of prostate adenocarcinoma with a diagnosis of ischemic stroke with hemorrhagic transformation. Bone scintigraphy with Tc-99m MDP supplemented with SPECT and fusion images with simple cerebral CT, performed at 15 days, shows uptake in the left temporal region, corresponding to stroke in subacute stage
Apresentamos o caso de um paciente com história de adenocarcinoma de próstata com diagnóstico de acidente vascular cerebral isquêmico com transformação hemorrágica. A cintilografia óssea com Tc-99m MDP suplementada com SPECT e imagens de fusão com TC cerebral simple, realizadas aos 15 dias, mostra captação na região temporal esquerda, correspondente ao ACV na fase subaguda
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Humanos , Masculino , Anciano de 80 o más Años , Medronato de Tecnecio Tc 99m , Accidente Cerebrovascular/diagnóstico por imagen , Cintigrafía , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
Antecedentes: El centellograma óseo se usa rutinariamente para estadificación y seguimiento de tumores malignos, especialmente de aquellos que con frecuencia dan origen a metástasis esqueléticas. Anormalidades costales múltiples alejadas de las articulaciones, son generalmente compatibles con metástasis. Pero por otro lado, un sitio solitario de hipercaptación puede no ser debido a la ya conocida enfermedad neoplásica, sino a un proceso benigno coexistente. Para evaluar la significación de este hallazgo, debe llevarse a cabo una biopsia a cielo abierto. Objetivo: Evaluar las biopsias radioguiadas, y la significación de un foco solitario de hipercaptación costal en pacientes neoplásicos o sospechosos de serlo. Lugar de aplicación: Centro oncológico universitario público. Diseño: Retrospectivo. Población: 23 pacientes con lesiones costales solitarias sospechosas de ser neoplásicas primitivas o bien metastásicas de tumores en actividad en algunos casos, o presumiblemente controlados en otros...
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Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Neoplasias Óseas , Costillas , Medronato de Tecnecio Tc 99m , Biopsia con Aguja , Neoplasias Óseas , Neoplasias de la Mama , Condroma , Neoplasias del Colon , Técnicas de Diagnóstico por Radioisótopo , Displasia Fibrosa Ósea , Displasia Fibrosa Ósea/diagnóstico , Fibromatosis Agresiva , Granuloma Eosinófilo , Granuloma Eosinófilo/diagnóstico , Enfermedad de Hodgkin , Neoplasias Renales , Neoplasias Pulmonares , Linfoma , Osteocondritis , Osteocondroma , Osteoma Osteoide , Osteomielitis , Plasmacitoma , Quistes Óseos , Quistes Óseos/diagnóstico , Estudios Retrospectivos , SarcomaRESUMEN
Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report on a male child followed for ten years since the age of 3 years and 9 months, when the diagnosis was made. He was born with bilateral hypoplasic hallux valgus and ventricular septal defect, corrected by transsternal approach when 32 months old. Restriction of neck mobility followed and foci of ectopic ossification appeared. Four crises of disease exacerbation were treated with oral prednisone and/or other antiinflammatory drugs. Sodium etidronate 5 to 10 mg/kg/day was prescribed intermittently during about six years but was discontinued due to osteopenia. The disease course has been relentless, with severe movement restriction including the chest wall. A review showed few similar case reports in the Brazilian literature. We revisit the criteria for diagnosis and the essentials of management and treatment.