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

left ventricular dyssynchrony in a patient with normal perfusion and stress induced left bundle branch block

n/

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

A Prospective, Randomized, Double-Blind Comparison of the Long-Term Effects of Metoprolol Versus Carvedilol

Background—Both metoprolol and carvedilol produce hemodynamic and clinical benefits in patients with chronic heart failure; carvedilol exerts greater antiadrenergic effects than metoprolol, but it is unknown whether this pharmacological difference results in hemodynamic and clinical differences between the 2 drugs. Methods and Results—We randomized 150 patients with heart failure (left ventricular ejection fraction ≤0.35) to double-blind treatment with either metoprolol or carvedilol. When compared with metoprolol (124±55 mg/d), patients treated with carvedilol (49±18 mg/d) showed larger increases in left ventricular ejection fraction at rest (+10.9±11.0 versus +7.2±7.7 U, P=0.038) and in left ventricular stroke volume and stroke work during exercise (both P<0.05) after 13 to 15 months of treatment. In addition, carvedilol produced greater decreases in mean pulmonary artery pressure and pulmonary wedge pressure, both at rest and during exercise, than metoprolol (all P<0.05). In contrast, the metoprolol gr..

F18-FDG-PET/CT in a patient affected by Lynch syndrome

Lynch syndrome (LS) is the most common hereditary syndrome that predisposes patients to colorectal cancer, and it accounts for 2&#8211;5% of the total burden of colorectal cancer. We report a case of a 61-year-old female affected by Lynch syndrome who underwent multiple adenocarcinoma resections, studied by F18-FDG-PET/CT for 5 years. This case report suggests a potential role of F18-FDG-PET/CT in the evaluation of patients affected by Lynch syndrome. Nuclear Med Rev 2010; 13, 2: 87&#8211;8

Radiolabelled PSMA PET/CT in breast cancer. A systematic review

BACKGROUND: Radiolabelled prostate-specific membrane antigen (PSMA)-based PET/CT is a whole-body imaging technique currently performed for the detection of prostate cancer lesions. PSMA has been also demonstrated to be expressed by the neovasculature of many other solid tumours. The aim of this review is to evaluate the possible diagnostic role of radiolabelled PSMA PET/CT in breast cancer. MATERIAL AND METHODS: A comprehensive literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases was conducted to find relevant published articles about the diagnostic performance of radiolabelled PSMA PET/CT in breast cancer. RESULTS: The comprehensive computer literature search revealed 652 articles. On reviewing the titles and abstracts, 640 articles were excluded because the reported data were not within the field of interest of this review. Twelve articles were selected and retrieved in full-text version; no additional study was found when screening the references of these articles. In total, 12 articles were included in the systematic review. CONCLUSIONS: Further studies enrolling a wider population are needed to clarify th