68Ga-DOTANOC PET/CT Detects a Rare Case of Metastatic Neuroendocrine Neoplasm of the Gallbladder.

ABSTRACT: Gallbladder neuroendocrine neoplasms (NENs) are rare tumors of the biliary system. These neoplasms express somatostatin receptors, and hence radiolabeled somatostatin analog 68Ga-DOTANOC is used as a PET radiotracer in detection and staging. Gallbladder NEN cannot be differentiated from an adenocarcinoma of the gallbladder based on clinical symptoms or routine radiological imaging such as ultrasound or CT. These are either diagnosed postcholecystectomy or after biopsy from primary or metastatic sites. We present a rare case of gallbladder NEN detected on 68Ga-DOTANOC PET/CT.

Physiologic Testicular Uptake of 18-F Fluorodeoxyglucose in the Indian Population.

OBJECTIVE: The objective of the study is to assess the physiologic uptake of testes in patients undergoing 18F-fluoro-2-deoxyglucose (FDG) position emission tomography/computed tomography (PET/CT) scans for various malignancies other than testicular malignancy. MATERIALS AND METHODS: The testicular uptake of 18F-FDG expressed as the standardized uptake value (T) was measured on PET/CT images in 320 men with no known testicular pathology from July 2019 to March 2020 at Tata Main Hospital, Jamshedpur. The ratio of maximum standardized uptake value (SUVmax) of the testis (T) to SUVmax of muscle (M) T/M ratio and to SUVmax of the liver (L) T/L ratio was calculated using SUVmax of right adductor muscle and liver, respectively. Testicular volume was calculated with the measurements taken from the axial, coronal, and sagittal slices of CT images. The correlation of testicular uptake with age, blood serum glucose level, and testicular volume was also analyzed. RESULTS: The mean age of 320 men was 57 ± 15 years (range: 10-94) and the mean blood glucose level was 107.7 ± 23.5 mg/dl (range: 64-175). Mean testicular SUVmax in 320 men was 2.48 ± 0.80 (range: 0.67-5.5). The mean testicular volume of 640 testes of 320 men was 18.80 ± 4.83 cm3 (range: 3.85-33.56 cm3). The mean values of (T/M) and (T/L) ratios in the studied population were 3.64 ± 1.21 (range: 1.08-5.58) and 0.97 ± 0.251 (range: 0.34-1.88), respectively. The laterality index (L - R/(L + R) ×2) in 320 men was 0.074 ± 0.050 (0.000-0.308). There was a minimal negative correlation between testicular SUVmax and age (r = -0.136, P = 0.15). Mild negative correlation was noted between T/M ratio and age (r = -0.291, P < 0.0001) and between T/L ratio and age (r = -0.182, P = 0.001) in the studied population. CONCLUSION: The physiological testicular FDG uptake (SUVmax) of testes was 2.48 ± 0.80 (0.67-5.5) among the Indian population in this study, which has a mild negative correlation with age.

High Glucose Metabolism in the Right Ventricular Myocardium Due to Extrinsic Pulmonary Stenosis by Mediastinal Lymphoma.

Acquired pulmonary stenosis in adults is rare and is usually caused by extrinsic compression from a mediastinal tumor. We present a case of anterior mediastinal Hodgkin lymphoma, who presented with cough and hemoptysis. Compression of the bilateral pulmonary arteries by the mediastinal mass was demonstrated by transthoracic echocardiography and CT pulmonary angiography. FDG PET/CT showed diffusely increased FDG uptake in right ventricular myocardium in addition to lymphomatous involvement of the lymph nodes and spleen.

Rare Case of Docetaxel-Induced Myositis Detected on Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in a Patient with Carcinoma Breast.

We report an extremely rare case of acute inflammatory myopathy during combination chemotherapy with docetaxel and transtuzumab for metastatic breast carcinoma in a 44-year-old female patient. Despite the significant response in the follow-up fluorodeoxyglucose (FDG) positron emission tomography/computed tomography, of the underlying malignancy to the chemotherapeutic regimen, there was diffusely increased FDG uptake in the upper and lower limb muscles with associated painful, proximal muscle weakness. These symptoms regressed after the discontinuation of docetaxel and the administration of corticosteroids, suggesting it to be the drug-induced myositis.

Rare Case of Cardiac Metastasis in a Patient with Cutaneous Squamous Cell Carcinoma of Foot Detected on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography.

Cutaneous squamous cell carcinoma (SCC) metastasizes most commonly to the regional lymph nodes and lungs. Metastasis to heart, although described in literature, is a very rare phenomenon. We present the 18F-fluorodeoxyglucose positron emission tomography-computed tomography findings in a 50-year-old woman who was a biopsy-proven case of SCC left foot, showing cardiac metastasis in addition to lymph nodes, lungs, and skeletal metastases.

Rare Case of Diffuse Splenic Uptake on Methylene Diphosphonate Bone Scan in a Patient with Sickle Cell Disease.

Extraskeletal tracer uptake in methylene diphosphonate (MDP) bone scan is not a common finding. There have been several case reports in the literature showing diffuse splenic uptake in MDP bone scan. We present a case of sickle cell disease, which showed diffuse splenic uptake on MDP whole-body bone scan.

Rare Presentation of Isolated Scar Site Recurrence in a Case of Carcinoma Cervix.

Scar site recurrence is a rare phenomenon and is even rarer in squamous cell carcinoma. We present a special case of isolated scar site recurrence in a patient with carcinoma cervix detected on fluorodeoxyglucose positron emission tomography-computed tomography, 2 years after hysterectomy and radiotherapy.