Hallazgos 18F-FDG PET/TC en osteoesclerosis inducida por hiperparatiroidismo sugerentes de metástasis osteomedulares difusas: importancia del signo de la «vértebra en camiseta de jugador de rugby» / Hyperparathyroidism-induced osteosclerosis mimicking diffuse osteo-medullary metastases on 18F-FDG PET/CT: The role of the «rugger jersey» spine sign

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Uterine leiomyosarcoma metastatic to thyroid shown by 18F-FDG PET/CT imaging / Metástasis tiroidea de un leiomiosarcoma uterino detectada mediante 18F-FDG PET/TC

About one third of focal thyroid uptakes in a fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) study are malignant, the most frequent histological type being papillary carcinoma. Metastases to the thyroid account for approximately 7.5% of thyroid malignancies and come mainly from kidney, lung, head and neck, and breast cancers. We report the case of a 64-year-old woman presenting a fast growing thyroid nodule whose primitive or metastatic origin was not obvious, for which 18F-FDG PET/CT helped in the diagnostic process and in the later management of the patient. Histopathologic findings finally revealed a metastasis of uterine leiomyosarcoma (AU)

En los estudios de tomografía por emisión de positrones/tomografía computarizada (PET/TC) con fluorodesoxiglucosa (FDG), aproximadamente un tercio de las captaciones focales tiroideas son de naturaleza maligna, siendo lo más frecuente el carcinoma papilar de tiroides. Las metástasis intratiroideas, menos frecuentes, representan un 7,5% de los casos y se originan principalmente en tumores primarios de riñón, pulmón, cabeza y cuello, y mama. Se describe el caso de una mujer de 64 años que presentó un nódulo tiroideo de rápido crecimiento, cuyo origen primario o metastásico no estaba claro, en el cual la 18F-FDG PET/TC fue útil en la aproximación diagnóstica y en el manejo clínico de la paciente. El posterior análisis por anatomía patológica de la lesión confirmó el diagnóstico de metástasis de leiomiosarcoma uterino (AU)

Uterine leiomyosarcoma metastatic to thyroid shown by 18F-FDG PET/CT imaging.

About one third of focal thyroid uptakes in a fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) study are malignant, the most frequent histological type being papillary carcinoma. Metastases to the thyroid account for approximately 7.5% of thyroid malignancies and come mainly from kidney, lung, head and neck, and breast cancers. We report the case of a 64-year-old woman presenting a fast growing thyroid nodule whose primitive or metastatic origin was not obvious, for which 18F-FDG PET/CT helped in the diagnostic process and in the later management of the patient. Histopathologic findings finally revealed a metastasis of uterine leiomyosarcoma.

Mejor rendimiento de la PET/TC con 18F-FDOPA para la detección de metástasis de un tumor neuroendocrino del íleon / Best sensitivity of 18F-FDOPA PET/CT to detect metastasis in one case of neuroendocrine tumour of the ileum

Los tumores neuroendocrinos (TNE) son un grupo de tumores muy heterogéneos y de distribución variable, lo que dificulta su localización anatómica. En medicina nuclear, durante décadas se han propuesto diferentes técnicas de imagen PET o SPECT con diversos radiotrazadores para el estudio de estos tumores, no existiendo consenso actualmente sobre la más adecuada, incluso al considerar solamente los TNE digestivos. Presentamos el caso de una mujer de 67 años con un TNE bien diferenciado del íleon en la que se sospechó una recidiva y ninguna técnica de imagen fue capaz de detectar la enfermedad, excepto la PET/TC con 18F-FDOPA. El seguimiento posterior mostró progresión de la enfermedad, confirmándose la positividad de este primer hallazgo. A raíz del caso se discuten y comparan los radiofármacos posibles para el diagnóstico de TNE digestivos, haciendo énfasis en los derivados embriológicamente del intestino medio (AU)

Neuroendocrine tumours (NET) are heterogeneous and frequently spread over the body, making their imaging difficult. With this aim, nuclear medicine imaging, using PET or SPECT with different tracers, has been proposed for decades, but there is currently no consensus on the most appropriate technique, even when only considering gastrointestinal NET. The case is presented of a 67year old woman with a well differentiated NET of the ileum with suspected recurrence, which was not detected by any imaging technique except 18F-FDOPA PET/CT. Subsequent follow up showed disease progression, which confirmed the true positivity of 18F-FDOPA. Using this case, we discuss and compare different radiotracers for the diagnosis of gastrointestinal NET, focusing on those embryologically originating from the mid-gut (AU)

Best sensitivity of 18F-FDOPA PET/CT to detect metastasis in one case of neuroendocrine tumour of the ileum. / Mejor rendimiento de la PET/TC con 18F-FDOPA para la detección de metástasis de un tumor neuroendocrino del íleon.

Neuroendocrine tumours (NET) are heterogeneous and frequently spread over the body, making their imaging difficult. With this aim, nuclear medicine imaging, using PET or SPECT with different tracers, has been proposed for decades, but there is currently no consensus on the most appropriate technique, even when only considering gastrointestinal NET. The case is presented of a 67year old woman with a well differentiated NET of the ileum with suspected recurrence, which was not detected by any imaging technique except 18F-FDOPA PET/CT. Subsequent follow up showed disease progression, which confirmed the true positivity of 18F-FDOPA. Using this case, we discuss and compare different radiotracers for the diagnosis of gastrointestinal NET, focusing on those embryologically originating from the mid-gut.