RESUMO
BACKGROUND: Epithelioid hemangioendothelioma (EHE) is an uncommon low-grade aggressive vascular tumor. It can occur in almost all locations, but is rarely encountered in bone. CASE SUMMARY: We report a 23-year-old man who presented with left hip pain with no obvious cause. X-ray revealed bone destruction in the left femoral neck with sclerosis at the edges of the lesions. Magnetic resonance imaging (MRI) showed bone destruction in the medullary cavity of the left femoral head and neck. 18F-deoxyglucose-positron emission tomography/computed tomography (PET/CT) imaging showed bone destruction in the left ischium, acetabulum, and left femoral head neck, accompanied by increased radioactive uptake; the maximum standard uptake value was 4.2. Histopathologic examination revealed spindle-shaped mesenchymal tissue hyperplasia with scattered epithelioid cells. The patient underwent left femoral head replacement surgery. No signs of recurrence were observed as of the 18-mo follow-up. CONCLUSION: The definitive diagnosis of femoral EHE can be established aided by the MRI and PET/CT findings.
RESUMO
The aim of this study was to evaluate the diagnostic criteria of dual time point Fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) in differentiating malignant from benign focal hypermetabolic lesions of duodenum.A total of 50 patients underwent F-FDG PET/CT at 2 points: 60â±â13.7âminutes (early imaging) and 120â±â26.4âminutes (delayed imaging) after tracer injection. Early maximum standardized uptake value (SUVE), delayed maximum standardized uptake value (SUVD), difference between early and delayed maximum standardized uptake value (D-SUVmax), and retention index (RI) were calculated for each duodenal lesion. Receiver operating characteristic analysis (ROC) was performed to evaluate the discriminating validity of the parameters.There were 32 malignant and 18 benign focal F-FDG uptake duodenal lesions. The values of SUVE, SUVD, and D-SUVmax were significantly different between malignant and benign lesions (12.5â±â6.3 vs 5.8â±â1.2, 13.5â±â6.5 vs 5.5â±â1.1 and 0.3â±â0.8 vs 1.0â±â1.0, respectively). The areas under the curves (AUCs) of SUVE, SUVD, D-SUVmax were 0.932, 0.964 and 0.707, respectively. There was no significantly difference between SUVE and SUVD based on AUC. In detecting malignant lesions, SUVE=6.9 yielded a sensitivity of 88.9% and specificity of 84.4%, SUVD=7.2 yielded a sensitivity of 94.6% and specificity of 90.6%, D-SUVmax=0.5 yielded a sensitivity of 72.2% and specificity of 68.8%. SUVD was the best diagnostic indicator, regarding specificity and specificity.SUVE and SUVD had good sensitivity, specificity for differentiating duodenal lesions. But there was no significantly difference between diagnostic value of SUVE and SUVD. F-FDG uptake patterns are helpful for differentiating benign and malignant duodenal lesions.
