18F-FDG PET/CT demonstrated renal and hepatic cyst infection in a patient with autosomal dominant polycystic kidney disease

Infection of renal or hepatic cyst is a serious complication of autosomal dominant polycystic kidney disease (ADPKD) and early diagnosis is crucial for the correct management. We report a case of 64-year-old male with ADPKD, who required renal transplantation some years before, with recent recurrent episodes of fever and abdominal pain, who underwent 18F-FDG PET/CT twice at 18 months intervals, after not conclusive conventional imaging studies (CT, ultrasonography). 18F-FDG PET/CT has proven to be a useful method for the diagnosis of renal and hepatic cyst infection in a patient with ADPKD and for the subse­quent management

Incidental thyroid Tc-99m methylene diphosphonate (MDP) uptake in a patient affected by polynodular goiter at bone scintigraphy

Incidental extraosseous uptake seen on Tc-99m methylene diphosphonate (MDP) bone scan is not unusual. We discuss here an incidental thyroid uptake in a 55-year-old female patient affected by breast cancer treated by total mastectomy, who underwent total body bone scintigraphy as a staging study. In the positron emission tomography era, traditional nuclear medicine imaging still has an important role in the diagnostic field, and incidental findings may be very useful in patient management, revealing unknown diseases and allowing correct therapeutic decisions

Incidental thyroid 99mTc-MDP uptake in a patient affected by differentiated thyroid cancer

We report a case of incidental uptake of 99mTc-methylene diphosphonate in the thyroid in a 62-year-old female with a history of breast cancer treated with quadrantectomy, chemotherapy and radiotherapy, who underwent total-body-bone scintigraphy during follow up. Planar scintigraphy was followed by neck SPECT-CT that demonstrated an area of increased tracer uptake in the neck at the left lobe of the thyroid. Neck ultrasonography showed a nodule corresponding to SPECT-CT finding and the ultrasound-guided fine needle aspiration documented the presence of papillary carcinoma. The patient underwent total thyroidectomy and ipsilateral lymphadenectomy; histological examination confirmed the presence of a papillary carcinoma and the patient underwent ablation therapy with iodine-131

Primary nasal-ethmoid choriocarcinoma detected by 18F-FDG PET/CT: a rare tumor with complete remission

Choriocarcinoma is a highly malignant and rare tumor characterized by secretion of the beta-subunit-of-humanchoriogonadotropin (β-HCG). We report a case of primary nasal choriocarcinoma with good response to chemotherapy. A 36-years-old woman gravida 0 and with history of 4 spontaneous abortion, in December 2018 referred to Otorhinolaryngology Department for repeated episodes of epistaxis. Cervical Magnetic Resonance Imaging (MRI) revealed a tumor mass involving right nasal cavity, right ethmoid, sphenoidal and maxillary sinuses. For a differential diagnosis between metastatic gestational choriocarcinoma and primary choriocarcinoma in January 2019 she underwent 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG-PET/CT) scan that demonstrated intense uptake only in the nasal-ethmoid tumor mass showed by MRI. This was suggestive of primary nasal-ethmoid choriocarcinoma she received 3 courses of BEP – regimen and after β-HCG was reduced to 500 mIU/mL and 18F-FDG-PET/CT scan showed a decreased uptake in tumor mass but the appearance of a new uptake in cervical lymph node which was analysed and reported as metastatic localization of choriocarcinoma. Therefore she was treated with 2 cycles of TIP-regimen. Subsequents 18F-FDG-PET/CT and MRI showed a complete tumor remission. This case proved the fundamental role of PET/CT to make diagnosis of primitive choriocarcinoma and to exclude the hypothesis of distant metastasis

Role of F-18-FDG-PET/CT in restaging of patients affected by gastrointestinal stromal tumours (GIST)

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are a subset of mesenchymal tumours that represent the most common mesenchymal neoplasms of the gastrointestinal (GI) tract and account for less than 1% of all gastrointestinal tumours. MATERIAL AND METHODS: We retrospectively evaluated 19 patients (6 females and 13 males; median age: 61 years ± 15 standard deviation) affected by GIST histologically documented after surgical intervention or biopsy. RESULTS: F18-FDG-PET/CT had identified pathologic uptakes and was considered positive for neoplastic tissue in 10 patients (53%) and negative in 9 (47%), in concordance with radiological findings. CONCLUSIONS: F18-FDG-PET/CT is a feasible, reliable, and accurate method to restage patients affected by previously histologically confirmed GIST, also in the absence of a staging study. Nuclear Med Rev 2010; 13, 2: 76–8

Primary breast non-Hodgkin lymphoma. A report of an unusual case

Although lymphomas are generally considered as tumors oflymph nodes about 25-40% arise at extranodal sites. We reporta case of a 60 years old female who developed a right breastB-diffuse large cell non-Hodgkin lymphoma in 2005 treated bychemo/radio-therapy which relapsed at the same breast in 2007and at the other breast in 2010. The patient underwent bothradiologic and nuclear medicine studies.Although lymphomas are generally considered as tumors oflymph nodes about 25-40% arise at extranodal sites. We reporta case of a 60 years old female who developed a right breastB-diffuse large cell non-Hodgkin lymphoma in 2005 treated bychemo/radio-therapy which relapsed at the same breast in 2007and at the other breast in 2010. The patient underwent bothradiologic and nuclear medicine studies

Incidental 18F-FDG PET/CT bilateral breast uptake due to carcinoma

We report a case of 71-year-old female patient, previously treated with chemotherapy and surgical resection of sigmoid tract of the large bowel for adenocarcinoma (pT3N1M0), who underwent a 18F-FDG PET/CT for a suspicious hepatic lesion detected at CT scan during follow-up. 18F-FDG PET/CT showed no abnormal uptake in the liver both at 60 minutes and 120 minutes after injection but revealed a pathological uptake in two breast nodules, (one localized in upper-internal-quadrant of the right breast and the other in the upper-external-quadrant of the left breast). The patient underwent breast MRI, which confirmed the suspicious nature of both lesions; subsequently she underwent a trucut biopsy of both lesions witch demonstrated a bilateral localization of papillary carcinoma (both lesion were classified as pT1c). The patient underwent bilateral mastectomy and the final biopsy confirmed the presence of breast cancer, while bilateral sentinel nodes biopsy showed no lymph-nodes metastases

The Management of Ruptured Abdominal Aortic Aneurysms: An Ongoing Challenge

Background: despite improvements in the diagnosis and treatment of elective AAAs, ruptured abdominal aortic aneurysms (RAAAs) continue to cause a substantial number of deaths. The choice between an open or endovascular approach remains a challenge, as does postoperative complications in survivors. The aim of this manuscript is to offer an overview of the contemporary management of RAAA patients, with a focus on preoperative and intraoperative factors that could help surgeons provide more appropriate treatment. Methods: we performed a search on MEDLINE, Embase, and Scopus from 1 January 1985 to 1 May 2023 and reviewed SVS and ESVS guidelines. A total of 278 articles were screened, but only those with data available on ruptured aneurysms' incidence and prevalence, preoperative scores, and mortality rates after emergency endovascular or open repair for ruptured AAA were included in the narrative synthesis. Articles were not restricted due to the designs of the studies. Results: the centralization of RAAAs has improved outcomes after both surgical and endovascular repair. Preoperative mortality risk scores and knowledge of intraoperative factors influencing mortality could help surgeons with decision-making, although there is still no consensus about the best treatment. Complications continue to be an issue in patients surviving intervention. Conclusions: RAAA still represents a life-threatening condition, with high mortality rates. Effective screening and centralization matched with adequate preoperative risk-benefit assessment may improve outcomes