This article reveals a clinical case dedicated to a young woman, professional athlete, who made an appointment at NN Blokhin Russian Cancer Research Center for differential diagnostics of left tibia bone lesion, diagnosed by local health facilities. There were no patient complaints during routine check-up. Oncologist made an appointment for bone scan and second opinion on CT scan (was also made). Incidental findings on scintigraphy required further investigation. So a decision to perform a hybrid SPECT/CT of pelvis, MRI of pelvis and left talocrural joint was made. After complete examination non-osteogenic fibroma of left tibia bone was set as diagnose. Also there were several unexpected findings such as stress fracture of the navicular bone of the left foot, prevalent fracture of the left ischium without signs of consolidation and with the formation (developing) of a false joint and heterotopic ossification in soft tissues and ankylosis of the intervertebral joint L5/S1. This findings more likely to be posttraumatic complications.
Erdheim–Chester disease (ECD) is a rare disease with a poor prognosis. The first two cases were reported by Jakob Erdheim and William Chester in 1930. The etiology and disease incidence are unknown. One of the main components of this disorder is a chronic uncontrollable inflammation. In 2016 ECD was classified as histiocytic neoplasm by the World Health Organization and was categorized as “tumors of histiocytes and dendritic cells”. More than half of patients testing positive for the BRAF mutation. The final diagnosis is made on the basis of histological finding. There are radiological markers indicating a possible association with the disease. This is a specific, almost pathognomonic scintigraphic picture of the skeleton, “coated” aorta, “hairy” kidney patterns on computer tomography. There is a Erdheim–Chester Disease Global Alliance (ECDGA), which try to unite and provide with information about diagnostics and treatment of this rare disease both patients and doctors. Today, there are 571 registered patients and only one from Russia. We demonstrate three clinical cases of patients with newly diagnosed ECD and the role of nuclear medicine methods in assessing the prevalence of this disease.
Purpose: To define the diagnostic capabilities of SPECT/CT in comparison with WBS in patients with bone metastases.
Material and methods: It was included 67 patients with bone metastases of breast cancer, prostate cancer and other tumors. The evaluation was included WBS and SPECT/CT.
Results: All patients were divided into 2 groups: with single and multiple metastases. SPECT/CT showed higher efficiency in detecting bone metastases than WBS. The full detection of bone metastases with WBS ranged from 31 to 56 % compared to SPECT/CT for groups respectively. In some cases (for groups respectively 4 % to 9.5 % depending on the number of metastases and their localization) of WBS was not informative, recorded the absence of lesions.
Conclusion: SPECT/CT can improve the diagnosis of bone metastasis.
Chondrosarcoma is one of the most common tumors in adults. Correct grading of chondrosarcoma is the most important criterion that defines the course of surgical treatment. A case report of a 56 years old female patient with chondrosarcoma of the pelvic bone is presented. The assistance of magnetic resonance tomography in accurate grading of the tumor is shown.
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