Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass. Findings by Tc-99m-MDP, F-18-FDG PET/CT and (99)mTc-MIBI scans
Küçük Resim Yok
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
HELLENIC SOC NUCLEAR MEDICINE
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Brown tumor is one of the skeletal manifegtations of hyperparathyroidism. It is a benign but locally aggressive bone lesion and its differential diagnosis with giant cell containing skeletal tumors or metastases may be complicated. We present a male patient with chronic renal failure who was initially misdiagnosed as having a giant-cell rich neoplasm of bone in his right thumb. Diffusely increased fluorine-18 fluorodeoxyglucose (F-18-FDG) uptake in the axial and appendicular skeleton and multiple F-18-FDG avid lytic lesions suggesting multiple metastases were observed on the F-18-FDG positron emission tomography/computed tomography (PET/CT) scan. On the usual technetium-99m methylene diphosphonate (Tc-99m-MDP) bone scan we noticed diffusely increased uptake in the skeleton and two focuses with very much increased uptake, which suggested a metabolic bone disease rather than a multiple metastatic giant cell tumor or bone metastases. Additional investigation documentated increased levels of parathyroid hormone. Parathyroid hyperplasia was finally diagnosed with Tc-99m-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy. Fluorine-18-FDG avid lytic lesions were attributed to hyerparathyroidism associated brown tumors instead of multiple metastases. In conclusion, we present a patient with chronic renal insufficiency, who suffered from secondary and later from tertiary HPT with polyostotic brown tumors, which were best shown by the F-18-FDG PET/CT than by the Tc-99m-MDP or the Tc-99m-MIBI scans.
Açıklama
Anahtar Kelimeler
Giant cells tumor, Brown tumor, Hyperparathyroidism, Tertiary HPT, PET/CT, Tc-99m-MDP and Tc-99m-MIBI scans
Kaynak
HELLENIC JOURNAL OF NUCLEAR MEDICINE
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
17
Sayı
3
