Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.
Adolescent ; Adult ; Bone Neoplasms ; Congenital Abnormalities ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic* ; Frontal Bone ; Frontal Sinus ; Headache ; Humans ; Mass Screening ; Nasal Septum ; Neurosurgery ; Orbit ; Otolaryngology ; Physicians, Family ; Primary Health Care* ; Radionuclide Imaging ; Watchful Waiting ; Young Adult

This is a case of a 54-year-old male, diagnosed to have insular thyroid carcinoma. The histopathologic characteristic of this rare neoplasm arising from follicular epithelial cells has the potential to take up 1-131 As shown in his postoperative 1-131 imaging, there are iodine-avid lesions in the parietal bone, thyroidal beds, ribs and vertebrae. The presence of these lesions in a &agnostic radioactive iodine scan makes it possible to do radioactive iodine therapy. A follow-up diagnostic study with 1-131 shows interval resolution and regression of the metastatic lesions. Thus, radioactive iodine therapy has a role in the treatment of this rare and aggressive neoplasm.

Human ; Male ; Middle Aged ; Iodine ; Parietal Bone ; Thyroid Neoplasms ; Iodides ; Radionuclide Imaging ; Ribs ; Epithelial Cells

This is a case of a 54-year-old male, diagnosed to have insular thyroid carcinoma. The histopathologic characteristic of this rare neoplasm arising from follicular epithelial cells has the potential to take up 1-131 As shown in his postoperative 1-131 imaging, there are iodine-avid lesions in the parietal bone, thyroidal beds, ribs and vertebrae. The presence of these lesions in a &agnostic radioactive iodine scan makes it possible to do radioactive iodine therapy. A follow-up diagnostic study with 1-131 shows interval resolution and regression of the metastatic lesions. Thus, radioactive iodine therapy has a role in the treatment of this rare and aggressive neoplasm.

Human ; Male ; Middle Aged ; Iodine ; Parietal Bone ; Thyroid Neoplasms ; Iodides ; Radionuclide Imaging ; Ribs ; Epithelial Cells

No abstract available.
Bone Marrow/*pathology/radiography/radionuclide imaging ; Carcinoma, Adenoid Cystic/*diagnosis ; Eye Neoplasms/*diagnosis ; Female ; Humans ; Lacrimal Apparatus/*pathology/radiography/radionuclide imaging ; Lacrimal Apparatus Diseases/*diagnosis ; Maxilla ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; *Positron-Emission Tomography ; *Tomography, X-Ray Computed

Malignant bone tumors would be classified as primary malignant bone tumors, secondary malignant bone tumors, and metastatic bone tumors. Primary malignant bone tumors are rare diseases occupying 1% of adult cancers, and 6% of pediatric cancers. The chief complaint of malignant bone tumor patients is pain different from that of malignant soft tissue tumor patients. Diagnostic procedures start with clinical evaluation including current illness, past medical history, family history, and physical examination. Then we take a radiograph first and obtain important and diagnostic clues from it. However pathological diagnosis and information about the extent of tumor are required to obtain a more definite diagnosis and staging. Examinations for detection of local and systemic tumor extent are scintigraphy, computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT. If the clinical and radiographic information suggests aggressive or malignant bone tumor, the patient should be referred to a bone tumor specialist without further evaluations.
Adult ; Biopsy ; Bone Neoplasms ; Diagnosis ; Electrons ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Radionuclide Imaging ; Rare Diseases ; Specialization

Osseous hemangioma is a benign vascular tumor, and it usually occurs in the vertebrae and the skull. However, hemangiomas of flat bones are rare, and there are very few reports that describe the radiologic findings of osseous hemangioma of the ilium. We report a unique case of large cavernous hemangioma mimicking a chondrogenic malignant bone tumor originated from the ilium in a 22-year-old female. The mass showed stippled calcifications, heterogeneous enhancement with thick septa and enhanced soft tissue components on CT and MR, and also this mass demonstrated heterogeneous 2-fluoro [fluorine-18]-2-deoxy-D-glucose (18F-FDG) uptake on 18F-FDG PET/CT.
Bone Neoplasms/radionuclide imaging ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Hemangioma, Cavernous/*radionuclide imaging ; Humans ; Ilium/*blood supply ; Magnetic Resonance Imaging ; Positron-Emission Tomography and Computed Tomography ; Radiopharmaceuticals/*diagnostic use ; Young Adult

OBJECTIVE: Na18F bone positron emission tomography (bone PET) is a new imaging modality which is useful for the evaluation of bone diseases. Here, we compared the diagnostic accuracies between bone PET and bone scan for the detection of bone metastasis (BM). MATERIALS AND METHODS: Sixteen cancer patients (M:F = 10:6, mean age = 60 +/- 12 years) who underwent both bone PET and bone scan were analyzed. Bone PET was conducted 30 minutes after the injection of 370 MBq Na18F, and a bone scan was performed 3 hours after the injection of 1295 MBq 99mTc-hydroxymethylene diphosphonate. RESULTS: In the patient-based analysis (8 patients with BM and 8 without BM), the sensitivities of bone PET (100% = 8/8) and bone scan (87.5% = 7/8) were not significantly different (p > 0.05), whereas the specificity of bone PET (87.5% = 7/8) was significantly greater than that of the bone scan (25% = 2/8) (p < 0.05). In the lesion-based analysis (43 lesions in 14 patients; 31 malignant and 12 benign), the sensitivity of bone PET (100% = 31/31) was significantly greater than that of bone scan (38.7% = 12/31) (p < 0.01), and the specificity of bone PET (75.0% = 9/12) was also significantly higher than that of bone scan (8.3% = 1/12) (p < 0.05). The receiver operating characteristic curve analysis showed that bone PET was significantly more accurate than the bone scan in the patient (p = 0.0306) and lesion (p = 0.0001) based analyses. CONCLUSION: Na18F bone PET is more accurate than bone scan for BM evaluation.
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Bone Neoplasms/*radionuclide imaging/*secondary ; Diphosphonates/diagnostic use ; Female ; Fluorine Radioisotopes/diagnostic use ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Male ; Middle Aged ; Multimodal Imaging/methods ; Organotechnetium Compounds/diagnostic use ; Positron-Emission Tomography/*methods ; Retrospective Studies ; Sensitivity and Specificity ; Sodium/diagnostic use ; Tomography, X-Ray Computed/methods

No abstract available.
Bone Marrow Cells/pathology ; Bone and Bones/radionuclide imaging ; Female ; Humans ; Lung Neoplasms/diagnosis/radiography ; Middle Aged ; Multimodal Imaging ; Multiple Myeloma/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the application of ²⁰¹TI and (99m)Tc-MIBI scintigraphy in assessment of neoadjuvant chemotherapy for osteosarcoma.

METHODSTwenty-two patients with osteosarcoma underwent both ²⁰¹TI and (99m)Tc-MIBI scintigraphy. According to tumor necrosis rate (TNR), 22 patients were classified into three groups: Group 1(necrosis less than 50%), Group 2(50% ≊ 89% necrosis) and Group 3(necrosis greater than 90%). The uptake ratio(UR) was obtained in images before and after chemotherapy. The alteration ratio(AR) and tumor necrosis ratio (TNR) were calculated.

RESULTSIn ²⁰¹Tl images,UR(pre) and UR(post) (mean ± s.d.) of Group 1 were 2.14 ± 0.67, 2.07 ± 0.71 (P>0.05); UR(pre) and UR(post)of Group 2 were 3.45 ± 1.57 and 2.02 ± 0.97 (P<0.01); UR(pre) and UR(post) of Group 3 were 3.57 ± 0.67 and 1.36 ± 0.20 (P<0.01). In (99m)Tc-MIBI images, UR(pre)and UR(post) of Group 1 were 1.66 ± 0.42 and 1.85 ± 0.70 (P>0.05); UR(pre) and UR(post) of Group 2 were 2.39 ± 1.41 and 1.68 ± 0.72 (P<0.05);UR(pre) and UR(post) of Group 3 were 2.56 ± 0.60 and 1.19 ± 0.14 (P<0.01). The AR value in (201)Tl scintigraphy was -0.03-0.72, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.95). The AR value in (99m)Tc-MIBI scintigraphy was -1.21-0.64, the liner regression analysis of AR versus TNR showed a highly significant positive correlation (r=0.71). The liner regression analysis of AR in ²⁰¹TI scintigraphy versus AR in (99m)Tc-MIBI scintigraphy showed a highly significant positive correlation (r=0.70).

CONCLUSIONThe AR changes significantly after neoadjuvant chemotherapy and is positively correlated with TNR, which indicates that ²⁰¹TI- and (99m)Tc-MIBI scintigraphy can be used for evaluation of neoadjuvant chemotherapy.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; drug therapy ; Child ; Female ; Humans ; Male ; Neoadjuvant Therapy ; Osteosarcoma ; diagnostic imaging ; drug therapy ; Preoperative Care ; Radionuclide Imaging ; Technetium Tc 99m Sestamibi ; Thallium Radioisotopes ; Young Adult

OBJECTIVETo investigate the indication of bone scan for patients with newly diagnosed prostate cancer.

METHODSThe clinical data of continual 95 patients with newly diagnosed prostate cancer was involved between January 2006 and December 2010. The relationship between age, PSA, Gleason scores, clinical stage and positive bone scans was respectively compared.

RESULTSThe 33 patients (34.7%) with positive bone scans and 62 patients (65.3%) with negative bone scans. The mean age was (74±7) years and (76±7) years respectively in 2 groups respectively. PSA was (70.7±38.1) ng/ml and (28.4±27.2) ng/ml respectively, the difference was significant (t=-5.499, P=0.000). Clinical stage had positive correlation with positive bone scan, the OR value was 4.684. If the Gleason score>7, the sensitivity, specificity, positive predictive value and negative predictive value of positive bone scan was 64%, 63%, 48% and 77% respectively. If PSA>50 ng/ml, sensitivity, specificity, positive predictive value and negative predictive value was 67%, 86%, 71% and 83% respectively. If Clinical stage>T2, sensitivity, specificity, positive predictive value and negative predictive value was 82%, 81%, 69% and 89% respectively.

CONCLUSIONSFor patients with PSA≤10 ng/ml or simultaneously PSA≤50 ng/ml and Gleason score≤7 and clinical stage≤T2, bone scan is not necessary. Patients with newly diagnosed prostate cancer and PSA>50 ng/ml or Gleason score>7 or clinical stage>T2 should undergo bone scan.

Aged ; Aged, 80 and over ; Bone Neoplasms ; diagnostic imaging ; secondary ; Bone and Bones ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Radionuclide Imaging ; Retrospective Studies ; Sensitivity and Specificity