RESUMEN
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.
Asunto(s)
Carcinoma Neuroendocrino , Carcinoma de Células Pequeñas , Masculino , Humanos , Persona de Mediana Edad , Fluorodesoxiglucosa F18 , Tomografía Computarizada por Tomografía de Emisión de Positrones , Próstata , Tomografía de Emisión de Positrones , Carcinoma de Células Pequeñas/diagnóstico por imagen , Carcinoma Neuroendocrino/diagnóstico por imagenRESUMEN
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.
Asunto(s)
Carcinoma , Neoplasias del Pene , Neoplasias de la Próstata , Masculino , Humanos , Anciano de 80 o más Años , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Próstata/patología , Lisina , Urea , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/patología , Neoplasias del Pene/diagnóstico por imagenRESUMEN
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.
Asunto(s)
Adiposis Dolorosa , Masculino , Humanos , Persona de Mediana Edad , Adiposis Dolorosa/diagnóstico , Tomografía Computarizada por Tomografía de Emisión de PositronesAsunto(s)
Carcinoma/diagnóstico por imagen , Carcinoma/secundario , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/secundario , Tomografía Computarizada de Emisión de Fotón Único/métodos , Tomografía Computarizada por Rayos X/métodos , Radioisótopos de Itrio , Carcinoma/metabolismo , Neoplasias del Colon/diagnóstico por imagen , Neoplasias del Colon/metabolismo , Femenino , Humanos , Neoplasias Hepáticas/metabolismo , Persona de Mediana Edad , Técnica de Sustracción , Radioisótopos de Itrio/farmacocinéticaRESUMEN
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.
Asunto(s)
Fracturas Óseas/diagnóstico , Fracturas Espontáneas/diagnóstico , Neoplasias Primarias Múltiples/complicaciones , Neoplasias Primarias Múltiples/diagnóstico , Octreótido , Osteomalacia/diagnóstico , Osteomalacia/etiología , Anciano , Diagnóstico Diferencial , Femenino , Factor-23 de Crecimiento de Fibroblastos , Fracturas Óseas/etiología , Fracturas Espontáneas/etiología , Humanos , Radiofármacos , Imagen de Cuerpo EnteroAsunto(s)
Líquido Cefalorraquídeo , Hipotensión Intracraneal/diagnóstico , Efusión Subdural/diagnóstico , Anciano , Medios de Contraste , Diagnóstico Diferencial , Femenino , Gadolinio DTPA , Humanos , Hipotensión Intracraneal/fisiopatología , Imagen por Resonancia Magnética , Radiofármacos , Efusión Subdural/fisiopatología , Vértebras Torácicas , Tomografía Computarizada de Emisión , Tomografía Computarizada por Rayos XAsunto(s)
Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/etiología , Sarcoma/complicaciones , Sarcoma/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/complicaciones , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Medronato de Tecnecio Tc 99m/análogos & derivados , Anciano de 80 o más Años , Nalgas/diagnóstico por imagen , Humanos , Masculino , Cintigrafía , RadiofármacosRESUMEN
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.
