RESUMO
ABSTRACT: A 51-year-old man with newly diagnosed small cell neuroendocrine carcinoma of the prostate was referred for a staging 18 F-DCFPyL PET/CT, which showed a solitary metastasis in the left acetabulum. Subsequent 18 F-FDG PET/CT showed intense uptake throughout the prostate as well as extensive avid pelvic and thoracic nodal disease and redemonstration of the left acetabular metastasis. Despite initial metabolic response to treatment, subsequent 18 F-FDG PET 8 months later revealed significant progression of nodal disease above and below the diaphragm, as well as multiple new sites of metastases.
Assuntos
Carcinoma Neuroendócrino , Carcinoma de Células Pequenas , Masculino , Humanos , Pessoa de Meia-Idade , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Próstata , Tomografia por Emissão de Pósitrons , Carcinoma de Células Pequenas/diagnóstico por imagem , Carcinoma Neuroendócrino/diagnóstico por imagemRESUMO
ABSTRACT: An 83-year-old man was referred for an 18 F-DCFPyL PET scan for the evaluation of rising serum prostate-specific antigen level on the background of previous radical prostatectomy for prostate adenocarcinoma and urinary outflow tract obstruction requiring in-dwelling catheter insertion. The PET scan demonstrated focal increased activity (SUV max , 35.7) at the dorsal aspect of the mid penile shaft, with histopathological confirmation of penile metastasis from primary prostate cancer.
Assuntos
Carcinoma , Neoplasias Penianas , Neoplasias da Próstata , Masculino , Humanos , Idoso de 80 Anos ou mais , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Próstata/patologia , Lisina , Ureia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias Penianas/diagnóstico por imagemRESUMO
ABSTRACT: A 64-year-old man with recently diagnosed prostate adenocarcinoma and Gleason score 4 + 3 = 7 with a mildly elevated prostate-specific antigen of 5.17 µg/L was referred for 18 F-DCFPyL PET/CT for primary staging. The scan demonstrated incidental innumerable moderately avid subcutaneous nodules due to adiposis dolorosa (Dercum's disease), which is a rare adipose tissue disease.
Assuntos
Adipose Dolorosa , Masculino , Humanos , Pessoa de Meia-Idade , Adipose Dolorosa/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia ComputadorizadaAssuntos
Carcinoma/diagnóstico por imagem , Carcinoma/secundário , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Radioisótopos de Ítrio , Carcinoma/metabolismo , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/metabolismo , Feminino , Humanos , Neoplasias Hepáticas/metabolismo , Pessoa de Meia-Idade , Técnica de Subtração , Radioisótopos de Ítrio/farmacocinéticaRESUMO
Tumor-induced osteomalacia is typically caused by benign mesenchymal tumors of vascular or skeletal origin. Overexpression of fibroblast growth factor 23 (FGF-23) by these tumors is associated with decreased resorption of phosphate in the renal tubules. This phosphate wasting leads to the characteristic findings of hypophosphatemia and hyperphosphaturia. Chronic hypophosphatemia causes abnormal mineralization of bone, increased alkaline phosphatase and, in the longer term, osteomalacia. Localization and resection of the FGF-23-secreting tumor offers the best chance of cure. We report a case of a 74-year-old woman diagnosed with numerous fractures on bone scintigraphy. Bone biopsy confirmed osteomalacia. Biochemical investigations showed hypophosphatemia, hyperphosphaturia, and increased alkaline phosphatase, suggesting the presence of an FGF-23-secreting tumor. Biochemistry also showed hyperparathyroidism and subclinical hyperthyroidism. Thyroid and parathyroid scintigraphy were performed and showed separate areas of focally increased tracer uptake in the neck. The patient underwent octreotide scintigraphy to localize an alternative site of tumor. This showed focally increased tracer uptake in the neck and in the abdomen. The patient underwent a hemithyroidectomy, parathyroidectomy, and adrenalectomy. Histopathology showed a papillary carcinoma of the thyroid, a parathyroid adenoma, and an adrenal adenoma. Postoperatively the patient showed rapid symptomatic and biochemical improvement.
Assuntos
Fraturas Ósseas/diagnóstico , Fraturas Espontâneas/diagnóstico , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/diagnóstico , Octreotida , Osteomalacia/diagnóstico , Osteomalacia/etiologia , Idoso , Diagnóstico Diferencial , Feminino , Fator de Crescimento de Fibroblastos 23 , Fraturas Ósseas/etiologia , Fraturas Espontâneas/etiologia , Humanos , Compostos Radiofarmacêuticos , Imagem Corporal TotalAssuntos
Líquido Cefalorraquidiano , Hipotensão Intracraniana/diagnóstico , Derrame Subdural/diagnóstico , Idoso , Meios de Contraste , Diagnóstico Diferencial , Feminino , Gadolínio DTPA , Humanos , Hipotensão Intracraniana/fisiopatologia , Imageamento por Ressonância Magnética , Compostos Radiofarmacêuticos , Derrame Subdural/fisiopatologia , Vértebras Torácicas , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios XAssuntos
Dor Lombar/diagnóstico , Dor Lombar/etiologia , Sarcoma/complicações , Sarcoma/diagnóstico por imagem , Neoplasias de Tecidos Moles/complicações , Neoplasias de Tecidos Moles/diagnóstico por imagem , Medronato de Tecnécio Tc 99m/análogos & derivados , Idoso de 80 Anos ou mais , Nádegas/diagnóstico por imagem , Humanos , Masculino , Cintilografia , Compostos RadiofarmacêuticosRESUMO
A 66-year-old woman was referred for a bone scan to assess back pain on a background of breast cancer, melanoma, and rheumatic heart disease. The scan appearance was suspicious for a localized soft tissue neoplasm. An FDG coincidence positron emission tomography (PET) study demonstrated a large FDG-avid soft tissue abnormality. Staphylococcus aureus was isolated from a subsequent needle biopsy. This case illustrates the use of FDG-PET in infection imaging, as well as demonstrating the potential pitfalls in nuclear oncology. Because FDG is not tumor-specific, accumulation in benign lesions may give rise to false-positive results despite a high pretest probability for malignancy.
