RESUMO
ABSTRACT: Thoracoabdominal duplication cysts are a congenital malformation of the posterior primitive foregut with synchronous thoracic and abdominal duplication cysts being found in up to 15% of cases. The presentation of duplication cysts depends on their location, size, and other factors, like the presence of ectopic functioning gastric mucosa, which is reported in 20%-30% of duplication cysts. 99mTc-pertechnetate scintigraphy along with SPECT/CT helps in the preoperative localization of ectopic functioning gastric mucosa in these duplication cysts. We report the scintigraphic and SPECT/CT findings of one such case, which helped in the final diagnosis and management of the patient.
Assuntos
Mucosa Gástrica , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Humanos , Abdome/diagnóstico por imagem , Coristoma/diagnóstico por imagem , Cistos/diagnóstico por imagem , Pertecnetato Tc 99m de Sódio/administração & dosagemRESUMO
Primary hyperparathyroidism is mostly caused by parathyroid adenoma(s) which are generally localized using routine imaging modalities such as neck ultrasonography and 99mTc-SestaMIBI scintigraphy. However, these can miss ectopic parathyroid adenomas due to their limited sensitivities. These ectopic lesions can later lead to failure of surgical excision and necessitate the need for a re-exploration. 18F-fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) can help in the localization of these ectopic adenomas due to its superior detection rates and spatial resolution. Herein, we report a case of ectopic parathyroid adenomas that were localized on FCH PET/CT.
RESUMO
Carcinoma en cuirasse is a type of cutaneous metastasis from different malignancies. En cuirasse although is a rare entity, most commonly occurs in cases of recurrent breast carcinoma after surgery or very rarely months or years after diagnosis of primary tumor. We report a rare case of neck carcinoma en cuirasse in a 47-year-old Indian female who is a known case of recurrent carcinoma left breast postmodified radical mastectomy, chemotherapy, and radiotherapy referred for fluorodeoxyglucose positron emission tomography-computed tomography following another six cycles of chemotherapy for response assessment.
RESUMO
ABSTRACT: Malakoplakia is a rare inflammatory disease that most frequently affects the urinary tract. We present the case of a patient who had been receiving treatment for breast cancer, who later on went on to develop diffuse large B-cell lymphoma for which she was started on RCHOP therapy. It was during her treatment that she underwent a whole-body 18F-FDG PET/CT for response evaluation and was incidentally diagnosed to have bilateral renal malakoplakia, which resolved after a prolonged course of antibiotic therapy.
RESUMO
Introduction: Recurrent/persistent primary hyperparathyroidism in patients who have undergone previous parathyroidectomy is a challenging condition. Imaging is important for localizing the parathyroid adenoma for re-exploration and 18F-Fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) seems ideal for this purpose. Aim: This prospective study attempted to ascertain the utility of 18F-FCH PET/CT as an investigation in preoperative localization of abnormal parathyroid tissue in recurrent/persistent primary hyperparathyroidism while comparing it with 99mTc-Sestamibi dual-phase scintigraphy with early single-photon emission CT (SPECT)/CT and neck ultrasonography (USG). Methods: Twenty patients with biochemical features of recurrent/persistent primary hyperparathyroidism were enrolled into this study. They underwent neck USG, 99mTc-Sestamibi dual-phase scintigraphy with early SPECT/CT and 18F-FCH PET/CT for localization of parathyroid lesions. Six patients underwent surgical resection of the detected lesions, 3 were awaiting surgery, and 11 were managed conservatively. One patient died due to COVID. Results: The calculated positive predictive values on a per-lesion basis of neck USG, 99mTc-sestamibi scintigraphy and early SPECT/CT and 18F-FCH PET/CT in the cohort of the 5 operated patients were 75% (3/4), 71.4% (5/7), and 71.4% (5/7), respectively. On a per-patient basis, the lesion detection rate was 100% for 99mTc-sestamibi scan and FCH PET (5/5) and 80% on neck USG (4/5). Conclusion: 18F-FCH PET/CT is a highly accurate imaging modality for the detection of parathyroid lesions in patients with recurrent/persistent primary hyperparathyroidism.
RESUMO
Introduction: Successful surgical treatment for primary hyperparathyroidism requires accurate localization of abnormal parathyroid tissue in terms of location and number. Imaging is important for localizing the parathyroid adenoma, and there has been significant interest in 18F-fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) for this purpose. Aim: This study attempted to ascertain the utility of 18F-FCH PET/CT as a first-line investigation in preoperative localization of abnormal parathyroid tissue in primary hyperparathyroidism, in comparison with 99mTc-sestamibi dual-phase scintigraphy with early single-photon emission computed tomography (SPECT)/CT and neck ultrasonography. Materials and Methods: Fifty-five patients with biochemical features of primary hyperparathyroidism were enrolled in this study. They underwent neck ultrasonography, 99mTc-sestamibi dual-phase scintigraphy with early SPECT/CT, and 18F-FCH PET/CT for localization of parathyroid lesions. Thirty-three patients underwent surgical resection of the detected lesions. For two patients, clinical and biochemical follow-up was used as a gold standard. Results: A total of 40 lesions were resected in the 33 patients who underwent surgery. A further two lesions were localized in two patients with clinical and biochemical follow-up as the gold standard. Of these 42 lesions, 41 were detected in preoperative imaging and 1 lesion was noted intraoperatively and resected. 41/42 lesions were detected by 18F-FCH PET/CT (detection rate: 97.6%), 33/42 by 99mTc-sestamibi dual-phase scintigraphy with early SPECT/CT (detection rate: 78.5%), and 30/42 by neck ultrasonography (detection rate: 71.4%). Conclusion: Detection rates on 18F-FCH PET/CT were superior to both 99mTc-sestamibi dual-phase scintigraphy with early SPECT/CT and neck ultrasonography in preoperative localization of parathyroid lesions in patients with primary hyperparathyroidism.
RESUMO
Retinoblastomas are the most common primary ocular malignancies in the pediatric population. They are known to undergo metastasis to distant sites like the bone marrow, lymph nodes, and skeleton, but liver metastasis is rare. 18F-fluorodeoxyglucose positron emission tomography-computed tomography is an interesting imaging technique that allows for staging for disease metastasis and plays a crucial role in treatment planning and prognostication of retinoblastoma patients with suspected distant metastasis. The case report highlights this very fact by demonstrating the case of a one-year-old boy with retinoblastoma that had metastasized to the skull bones and even the liver.
RESUMO
Inflammatory myofibroblastic tumors (IMT) are a rare set of tumors that have been reported in various areas of the body but not quite as often in systemic lymph nodes. Herein, we discuss the case of a 60-year-old woman who presented with bilateral cervical and axillary lymphadenopathy and a low-grade fever. She subsequently underwent a fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) as part of her evaluation. The scan revealed multiple hypermetabolic cervical, axillary, mediastinal, retroperitoneal, pelvic, and inguinal lymph nodes of various dimensions scattered throughout her body. Based on these findings, she was erroneously diagnosed to have lymphoma. It was only after histopathological correlation was the diagnosis revised to that of IMT, after which she was started on a course of oral corticosteroids. On follow-up imaging, she showed evidence of complete resolution of the involved lymph nodes. She has been disease-free for the past nine months after completing treatment. This case highlights the importance of including IMT as part of the differential diagnosis in suspected cases of lymphoma, giving credence to the phrase "all that glitters is not gold."
RESUMO
Neuroendocrine tumors (NETs) are a rather uncommon cause of chronic non-bloody diarrhea and are therefore often left undiagnosed for prolonged periods of time. In this case, a 46-year-old man was inappropriately treated with antibiotics for months by various doctors, and by the time the diagnosis of NET was made, the tumor had already metastasized to the entire skeleton. The patient refused surgery and was started on octreotide, which resolved his diarrhea.
RESUMO
Spontaneous pneumomediastinum is a rare condition, characterized by the presence of air in the mediastinum without any apparent precipitating cause. It is mainly a radiological diagnosis. The onus of differentiating between secondary and spontaneous pneumomediastinum lies on a thorough workup. In addition to etiology, complications such as tension pneumomediastinum, cervical emphysema, and pneumorachis. When present, must be diagnosed promptly. Spontaneous pneumomediastinum is a benign condition which is usually managed conservatively. Although not routinely seen on positron emission tomography/computed tomography, when present, they must be picked up and reported accurately to guide appropriate management of the patient.