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Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease

We present the case of a large, painful pelvic bone tumor in a 53-year-old woman with severe Paget disease. Her presentation was complicated with bilateral total hip arthroplasty, history of spinal stenosis, and multiple lucent lesions in the spine and pelvis in severely affected pagetoid bone. This...

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Detalles Bibliográficos
Autores principales: Bush, Lisabeth Ann, Toresdahl, Brett, Hoch, Benjamin, Chew, Felix S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898074/
https://www.ncbi.nlm.nih.gov/pubmed/27307820
http://dx.doi.org/10.2484/rcr.v4i3.295
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author Bush, Lisabeth Ann
Toresdahl, Brett
Hoch, Benjamin
Chew, Felix S.
author_facet Bush, Lisabeth Ann
Toresdahl, Brett
Hoch, Benjamin
Chew, Felix S.
author_sort Bush, Lisabeth Ann
collection PubMed
description We present the case of a large, painful pelvic bone tumor in a 53-year-old woman with severe Paget disease. Her presentation was complicated with bilateral total hip arthroplasty, history of spinal stenosis, and multiple lucent lesions in the spine and pelvis in severely affected pagetoid bone. This case features the rare but dreaded complication of osteosarcomatous transformation in Paget disease. A variety of imaging modalities including PET/CT were utilized in the evaluation of these lesions. The PET/CT findings were counter-intuitive with regard to the intense uptake of the underlying chronic disease process and the near-absence of uptake in the tumors. The histology of the pelvic mass is also intriguing, as it demonstrated a sarcoma with giant cell features. Conservative, non-operative management was chosen, due to the patient’s poor medical condition, so we may never know the nature of the spinal lesion in this case, but will discuss the differential diagnosis for a lytic spinal lesion in a patient with severe Paget disease complicated by osteosarcoma with giant cell features.
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spelling pubmed-48980742016-06-15 Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease Bush, Lisabeth Ann Toresdahl, Brett Hoch, Benjamin Chew, Felix S. Radiol Case Rep Article We present the case of a large, painful pelvic bone tumor in a 53-year-old woman with severe Paget disease. Her presentation was complicated with bilateral total hip arthroplasty, history of spinal stenosis, and multiple lucent lesions in the spine and pelvis in severely affected pagetoid bone. This case features the rare but dreaded complication of osteosarcomatous transformation in Paget disease. A variety of imaging modalities including PET/CT were utilized in the evaluation of these lesions. The PET/CT findings were counter-intuitive with regard to the intense uptake of the underlying chronic disease process and the near-absence of uptake in the tumors. The histology of the pelvic mass is also intriguing, as it demonstrated a sarcoma with giant cell features. Conservative, non-operative management was chosen, due to the patient’s poor medical condition, so we may never know the nature of the spinal lesion in this case, but will discuss the differential diagnosis for a lytic spinal lesion in a patient with severe Paget disease complicated by osteosarcoma with giant cell features. Elsevier 2015-12-07 /pmc/articles/PMC4898074/ /pubmed/27307820 http://dx.doi.org/10.2484/rcr.v4i3.295 Text en © 2009 The Authors. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Bush, Lisabeth Ann
Toresdahl, Brett
Hoch, Benjamin
Chew, Felix S.
Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title_full Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title_fullStr Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title_full_unstemmed Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title_short Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease
title_sort falsely negative f-18 fdg pet of osteosarcoma arising in paget disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898074/
https://www.ncbi.nlm.nih.gov/pubmed/27307820
http://dx.doi.org/10.2484/rcr.v4i3.295
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