The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the detection of brown tumors: A case series
We present two cases of chronic hemodialysis patients with suspicious lytic pelvic bone lesions in the context of secondary hyperparathyroidism (HPT). Bone biopsies were inconclusive. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans revealed highly hypermetabolic lytic lacunar bone lesions scattered throughout the skeleton. Pathological 99mTc-hexakis-methoxy-isobutyl-isonitrile (99mTc-MIBI) uptake in the cervical region suggested parathyroid tissue involvement, while whole-body 99mTc-MIBI scintigraphy did not reveal pathological uptake. Brown tumors were strongly suspected based on clinical and laboratory evidence of HPT, ruling out malignancy. Our cases suggest the superior sensitivity of 18F-FDG PET/CT in detecting and characterizing brown tumors compared to whole-body 99mTc-MIBI scintigraphy. This examination offers crucial insights into characterizing brown tumors based on morpho-metabolic criteria, minimizing inaccurate diagnosis of this pathological condition.
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