Scopus
Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass. Findings by <sup>99m</sup>Tc-MDP, <sup>18</sup>F-FDG PET/CT and <sup>99m</sup>Tc-MIBI scans
Hellenic Journal of Nuclear Medicine · Eylül 2014
Makale Bilgileri
DergiHellenic Journal of Nuclear Medicine
Yayın TarihiEylül 2014
Cilt / Sayfa17 · 214-217
Scopus ID2-s2.0-84919953337
Özet
Brown tumor is one of the skeletal manifestations 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 (18F-FDG) uptake in the axial and appendicular skeleton and multiple 18F-FDG avid lytic lesions suggesting multiple metastases were observed on the 18F-FDG positron emission tomography /computed tomography (PET/CT) scan. On the usual technetium-99m methylene diphosphonate (99mTc- 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 99mTc-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 18F-FDG PET/CT than by the 99mTc-MDP or the 99mTc-MIBI scans.
Yazarlar (4)
1
G. K. Gedik
2
Özlem Ata
3
Pınar Karabağlı
ORCID: 0000-0002-5558-0175
4
Oktay Sari
Anahtar Kelimeler
99m 99m TC-MDP and TC-MIBI scans
Brown tumor
Giant cells tumor
Hyperparathyroidism
PET/CT
Tertiary HPT
Kurumlar
Selçuk Tip Fakültesi
Konya Turkey
Metrikler
11
Atıf
4
Yazar
6
Anahtar Kelime