Manas Kumar Sahoo

Recurrent dermatofibrosarcoma protuberans with pulmonary metastases presenting twelve years after initial diagnosis: 18F-FDG PET/CT imaging findings.

Dermatofibrosarcoma protuberans is a rare cutaneous tumor that is locally aggressive and has a high rate of recurrence after surgical excision. The tumor grows slowly, typically over years. On rare occasions, metastasis to distant sites (especially the lung) or regional lymph nodes may occur. Here, we present F-FDG PET/CT imaging findings of a 52-year-old man with a local recurrence of dermatofibrosarcoma protuberans in the anterior abdominal wall with metastases to bilateral lungs.

Necrolytic migratory erythema associated with glucagonoma syndrome diagnosed by ⁶⁸Ga-DOTANOC PET-CT.

Necrolytic migratory erythema (NME) is a rare dermatological condition which presents a diagnostic challenge. Repeated negative skin biopsies and non‐detection of any pancreatic tumor in conventional imaging modalities like a computed tomography (CT) scan and ultrasonogram (USG) make the diagnosis more difficult. By the time the diagnosis is made, the patient usually presents with metastasis. We present a rare case of difficult to diagnose NME, as repeated skin biopsies and conventional imaging modalities like CT and USG could not detect the underlying glucagonoma. A 68Ga‐DOTANOC positron emission tomography PET‐CT was able to detect the underlying cause of NME as glucagonoma of the pancreas and the same investigation confirmed the absence of any metastasis elsewhere in the body. The tumor was excised and patient dramatically improved, and all skin lesions disappeared.

Pulmonary alveolar microlithiasis: imaging characteristics of planar and SPECT/CT bone scan versus 18F-FDG and 18F-sodium fluoride PET/CT scanning

Pulmonary alveolar microlithiasis (PAM) is a very rare disease in which multiple microscopic calcium phosphate microliths are deposited within the alveoli of both lungs. A lung biopsy is considered to be definitive for final diagnosis; however, non-invasive imaging modalities such as chest X-ray, HRCT scan and 99mTc-MDP bone scan suggest the diagnosis in the vast majority of patients. Although 18F-FDG PET/CT has been tried to characterize the disease, 18F-sodium fluoride PET/CT as a ‘proof-of-principle’ was tried for the first time in a known case of PAM in order to characterize the lung lesions. Interestingly, we noted that 18F-sodium fluoride PET/CT is a superior modality in characterization and assessment of the extent of disease in PAM compared to all other non-invasive imaging modalities. Thus, we recommend that 18F-sodium fluoride PET/CT should be the investigation of choice in PAM.

Solitary breast metastasis from recurrent gallbladder carcinoma simulating a second primary on 18F-FDG PET/CT.

Gallbladder carcinoma is characterized by poor prognosis. It spreads by direct, lymphatic, vascular, neural, intraperitoneal, and intraductal routes. The most commonly involved organ is the liver followed by regional lymph nodes. Extra-abdominal metastases are comparatively rare. We present a case of solitary breast metastasis from recurrent gallbladder carcinoma mimicking a primary breast cancer in (18)F-FDG PET/CT.

Schmorl's node mimicking metastasis in a patient with breast cancer: diagnosis with 99mTC methylene diphosphonate SPECT-CT.

Schmorls node (SN) is a common entity characterized by protrusion of intervertebral disc material through a break in the subchondral end plate of a vertebral body. They can show increased 99mTC methylene diphosphonate uptake on bone scintigraphy mimicking metastasis and can be symptomatic. Differentiation of SN from metastasis is essential for appropriate patient management. Here, we present a case where increased 99mTC methylene diphosphonate uptake in a dorsal vertebra was found to be because of SN by using single-photon emission computed tomography-computed tomography.

Gallbladder Carcinoma Metastasizing to Adrenal Gland: A Rare Site Demonstrated With 18F-FDG PET/CT

Adrenal metastases have commonly been reported in a wide variety of cancers but not in gallbladder cancer. We here present a case of a 45-year-old male patient with gallbladder carcinoma where left adrenal metastasis was detected on staging F-FDG PET/CT. This was confirmed histopathologically. F-FDG PET/CT can have a significant impact on management of patients with gallbladder carcinoma by demonstrating rare sites of metastasis.

Radioiodine avid axillary lymph node metastasis in papillary thyroid cancer: report of a case.

Differentiated thyroid cancer (DTC) is the most common endocrine neoplasm. Distant metastases occur in up to 10% of patients with DTC [1, 2]. They are the main cause of thyroid cancer related deaths but are compatible with long term survival in a large proportion of patients. Regional lymph node metastasis is a very frequent finding in DTC. However, non regional lymph node metastasis especially to the axillary nodes has been rarely reported in literature and it is not considered to be a typical site for metastasis from DTC [3].

Role of 99mTc-ECD SPECT in the management of children with craniosynostosis.

Purpose of the Report. There is a paucity of data on correlation of various imaging modalities with clinical findings in craniosynostosis. Moreover, no study has specifically reported the role of 99mTc-ECD SPECT in a large number of subjects with craniosynostosis. Materials and Methods. We prospectively analyzed a cohort of 85 patients with craniosynostosis from year 2007 to 2012. All patients underwent evaluation with 99mTc-ECD SPECT and the results were correlated with radiological and surgical findings. Results. 99mTc-ECD SPECT revealed regional perfusion abnormalities in the cerebral hemisphere corresponding to the fused sutures preoperatively that disappeared postoperatively in all the cases. Corresponding to this, the mean mental performance quotient (MPQ) increased significantly (P < 0.05) postoperatively only in those children with absent perfusion defect postoperatively. Conclusions. Our study suggests that early surgery and release of craniosynostosis in patients with preoperative perfusion defects (absent on 99mTc-ECD SPECT study) are beneficial, as theylead to improved MPQ after surgery.

FDG PET/CT in Carcinoma of the Tongue With Bilateral Adrenal Metastases

Squamous cell carcinoma is the most common malignant neoplasm of the oral cavity, and it contributes approximately 90% of all oral malignancies. We present a case of a squamous cell carcinoma of the tongue with rare site of bilateral adrenal metastases on F-FDG PET/CT with response evaluation after chemotherapy.

Philadelphia-Positive Acute Myeloblastic Leukemia: A Rare Entity

Philadelphia positive (Ph+) Acute Myeloblastic Leukemia (AML) is an acute onset neoplasm of myeloblasts in which the blasts harbor BCR/ABL translocation in the absence of a clinical history of chronic phase or accelerated phase chronic myeloid leukemia (CML) and a lack of clinical and laboratory features of CML, such as splenomegaly and basophilia.