Bone Metastasis from Renal Cancer Coinciding with the Same Anatomical Position as a Vertebral Hemangioma: A Collision Lesion Case Report.

Collisions lesions are rare neoplasms where two histologically distinct tumors coexist in the same organ or anatomical site. Vertebral hemangiomas (VHs) are the most common lesions involving the vertebral bodies and imaging findings of typical and atypical hemangiomas, variant forms of hemangioma such as aggressive hemangiomas are well known, but collision lesions involving VHs are extremely rare. This article presents a case report of a 73-year-old male patient diagnosed with clear cell renal cancer in a rare presentation of a bone metastasis coinciding with the same anatomical position as a VH (collision lesion). This required a multidisciplinary approach involving various diagnostic techniques to determine the best therapeutic management.

False-Positive Uptake in Splenic Hemangioma on 68Ga-PSMA PET/CT Scan for Late Biochemical Recurrence of Prostate Cancer.

ABSTRACT: A 71-year-old man underwent 68Ga-PSMA PET/CT for evaluation of a late biochemical recurrence after radical prostatectomy. An intense PSMA uptake was identified in spleen. Additional evaluation with a contrast-enhanced MRI showed a splenic lesion consistent with splenic hemangioma.

Single Adrenal Metastasis From Prostate Cancer Detected by 68Ga-PSMA PET/CT and Confirmed by Biopsy: A Case Report.

ABSTRACT: This image demonstrates an unusual presentation of an adrenal metastasis from prostate cancer detected by 68Ga-prostate-specific membrane antigen PET/CT and confirmed by biopsy. A 68-year-old man with prostate cancer persisted with elevated levels of prostate-specific antigen after radical prostatectomy. Imaging identified a single abnormal uptake in the left adrenal gland. A biopsy was performed showing a metastatic prostatic adenocarcinoma. The patient received systemic treatment, and his prostate-specific antigen level decreased significantly. Our objective is to illustrate an unusual and single site of prostate cancer metastasis, in which precise histological diagnosis was essential for correct clinical management of the patient.

Evaluation of the clinical use of PET/CT with 68Ga-PSMA for the assessment of biochemical recurrence of low or intermediate-risk prostate cancer.

RATIONALE: 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PET-PSMA) has shown promising performance for the assessment of biochemical recurrence of prostate cancer in high-risk patients, defined by D´Amico et al. criteria. Little evidence for the impact of this diagnostic method for patients at low or intermediate risk, in terms of management and benefits of subsequent treatment, is available. METHODS: Data from 57 patients with low and intermediate-risk prostate cancer and biochemical recurrence underwent PET-PSMA were examined retrospectively. Images were analyzed and findings were compared with clinical data. Indications for the PET-PSMA imaging, study positivity/negativity, lesion locations, Gleason (ISUP) score, prostate-specific antigen (PSA) level on the examination date, postexamination treatment, and management were evaluated. RESULTS: PET-PSMA findings were negative for 28 (49.12%) patients, 11 of whom received salvage radiotherapy (S-RT; with or without HT; PSA levels declined significantly in 10 (90.9%) of these patients compared with levels in those not undergoing S-RT. Positive PET-PSMA findings enabled the accurate identification of patients who benefited from salvage pelvic RT for local disease control and those who responded satisfactorily to systemic treatment. CONCLUSION: PET-PSMA is useful for the assessment of biochemical recurrence in prostate cancer patients with prostate cancer at low and intermediate-risk.

Diffuse pleural metastases of osteosarcoma detected by bone scan.

Osteosarcoma (OS) is a fast-growing tumor, with a high risk of local recurrence and distant metastases, with the lung and bone being the most common sites of dissemination occurring in approximately 80% of cases. Pleural metastases rarely occurs and the appearance of diffuse pleural thickening with ossification is not usual, with few such cases reported due to the current state-of-art treatment protocols. A 29-year-old woman, diagnosed with a proximal left tibial OS underwent planar and single-photon emission computed tomography/computed tomography bone scan scintigraphy with 99mtechnetium methylene diphosphonate showing bilateral pleural uptake, corresponding to multiple calcified foci of thickening and nodules.

Fibrous dysplasia as a possible false-positive finding in 68Ga-labeled prostate-specific membrane antigen positron emission tomography/computed tomography study in the follow-up of prostate cancer.

Positron emission tomography/computed tomography (PET/CT) using 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) has become an important tool in restaging patients with prostate cancer (PCa). Despite its high sensitivity and specificity, this method may produce false-positive findings, as indicated by previous studies. This case report aims to warn nuclear medicine physicians, oncologists, and urologists about the possibility of false-positive findings using this imaging modality, especially when the detected site is unusual for bone metastasis. A 68-year-old man with PCa underwent restaging tests after presenting with increased prostate-specific antigen. 68Ga-PSMA PET/CT imaging revealed abnormal uptake in the left humeral head, which anatomically corresponded to the intramedullary and cortical sclerotic area. A biopsy was performed, and the pathology showed a lesion consisting of hard bone tissue with a small focal spot of fibrous dysplasia. Diagnostic issues related to 68Ga-PSMA PET/CT imaging should be disseminated to help physicians make appropriate treatment choices for each patient.