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Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma

A craniofacial mass may cause the first clinical symptoms of malignancy. In pediatric patients, neuroblastoma, Langerhans cell histiocytosis (LCH), and acute lymphoblastic leukemia (ALL) are the most common diseases initially manifesting with bone lesions, and bone scintigraphy is a useful modality...

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Autores principales: Hosokawa, Takahiro, Uchiyama, Mayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171765/
https://www.ncbi.nlm.nih.gov/pubmed/37180176
http://dx.doi.org/10.4103/ijnm.ijnm_147_22
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author Hosokawa, Takahiro
Uchiyama, Mayuki
author_facet Hosokawa, Takahiro
Uchiyama, Mayuki
author_sort Hosokawa, Takahiro
collection PubMed
description A craniofacial mass may cause the first clinical symptoms of malignancy. In pediatric patients, neuroblastoma, Langerhans cell histiocytosis (LCH), and acute lymphoblastic leukemia (ALL) are the most common diseases initially manifesting with bone lesions, and bone scintigraphy is a useful modality to evaluate them. The purpose of this pictorial essay was to show the scintigraphy findings of the craniofacial bones in three patients, with neuroblastoma, ALL, and LCH, and to provide a useful scintigraphic sign to differentiate these diseases. In the bone scintigraphy of neuroblastoma with craniofacial bone metastases, strong tracer uptake was evident, resembling a carnival mask. In contrast, in the two cases with LCH and ALL involving the craniofacial bones, the tracer uptake was lower than in neuroblastoma and with different distributions. Bone metastases of neuroblastoma usually occur in the periorbital craniofacial bones, and these metastases may be locally aggressive, destroying the bones; which show stronger uptake than other cranial bones. LCH is associated with varying degrees of disease activity, and its bone imaging findings differ based on its activity. Therefore, these lesions present low uptake in bone scintigraphy, showing as “cold spots”. Therefore, LCH scintigraphy of the craniofacial bones does not resemble a carnival mask. The bone marrow infiltration by leukemic cells usually shows as diffuse bone marrow. Therefore, in bone scintigraphy of leukemia, the tracer uptake in the periorbital craniofacial bones is similar to other cranial bones, not presenting as a carnival mask. In conclusion, bone scintigraphy to evaluate malignant craniofacial lesions could provide useful differential diagnostic information.
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spelling pubmed-101717652023-05-11 Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma Hosokawa, Takahiro Uchiyama, Mayuki Indian J Nucl Med Pictorial Essay A craniofacial mass may cause the first clinical symptoms of malignancy. In pediatric patients, neuroblastoma, Langerhans cell histiocytosis (LCH), and acute lymphoblastic leukemia (ALL) are the most common diseases initially manifesting with bone lesions, and bone scintigraphy is a useful modality to evaluate them. The purpose of this pictorial essay was to show the scintigraphy findings of the craniofacial bones in three patients, with neuroblastoma, ALL, and LCH, and to provide a useful scintigraphic sign to differentiate these diseases. In the bone scintigraphy of neuroblastoma with craniofacial bone metastases, strong tracer uptake was evident, resembling a carnival mask. In contrast, in the two cases with LCH and ALL involving the craniofacial bones, the tracer uptake was lower than in neuroblastoma and with different distributions. Bone metastases of neuroblastoma usually occur in the periorbital craniofacial bones, and these metastases may be locally aggressive, destroying the bones; which show stronger uptake than other cranial bones. LCH is associated with varying degrees of disease activity, and its bone imaging findings differ based on its activity. Therefore, these lesions present low uptake in bone scintigraphy, showing as “cold spots”. Therefore, LCH scintigraphy of the craniofacial bones does not resemble a carnival mask. The bone marrow infiltration by leukemic cells usually shows as diffuse bone marrow. Therefore, in bone scintigraphy of leukemia, the tracer uptake in the periorbital craniofacial bones is similar to other cranial bones, not presenting as a carnival mask. In conclusion, bone scintigraphy to evaluate malignant craniofacial lesions could provide useful differential diagnostic information. Wolters Kluwer - Medknow 2023 2023-02-24 /pmc/articles/PMC10171765/ /pubmed/37180176 http://dx.doi.org/10.4103/ijnm.ijnm_147_22 Text en Copyright: © 2023 Indian Journal of Nuclear Medicine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Pictorial Essay
Hosokawa, Takahiro
Uchiyama, Mayuki
Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title_full Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title_fullStr Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title_full_unstemmed Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title_short Carnival Mask Sign on Bone Scan of Craniofacial Metastasis of Neuroblastoma
title_sort carnival mask sign on bone scan of craniofacial metastasis of neuroblastoma
topic Pictorial Essay
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171765/
https://www.ncbi.nlm.nih.gov/pubmed/37180176
http://dx.doi.org/10.4103/ijnm.ijnm_147_22
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