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      Brown Tumors Due to Primary Hyperparathyroidism in a Patient with Parathyroid Carcinoma Mimicking Skeletal Metastases on 18F-FDG PET/CT

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      Author(s): * ,
      Editor(s):
      Publication date (Electronic):
      Journal: Diagnostics
      Publisher: MDPI
      Keywords: brown tumors, parathyroid carcinoma, FDG PET, primary hyperparathyroidism

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          Abstract

          Parathyroid carcinoma only represents <1% of all cases of primary hyperparathyroidism (PHPT). Even rare, chronic PHPT may lead to excessive osteoclast activity, and the increased resorption leads to destruction of cortical bone and formation of fibrous cysts with deposits of hemosiderin—so-called brown tumors. These benign, osteolytic lesions may demonstrate FDG-avidity on 18F-FDG PET/CT, and as such are misinterpreted as skeletal metastases. Regression of the lesions may occur following successful treatment. We present a case demonstrating the diagnostic work-up and follow-up of a patient with PHPT due to parathyroid carcinoma and with presence of brown tumors on 18F-FDG PET/CT, visualizing the possible role of this imaging modality in the evaluation of treatment response in these patients.

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          Prognostic factors and staging systems in parathyroid cancer: a multicenter cohort study.

          Jesús Villar-Del-Moral, Marco Antonio Jiménez García, Pilar Salvador-Egea … (2014)
          Parathyroid carcinoma (PC) is an uncommon disease that generally is detected postoperatively and traditionally is associated with a poor prognosis. Our purpose was to evaluate treatment outcomes, prognostic factors, and usefulness of some proposed staging systems for this disease.
          Article 0 comments Cited 25 times – based on 0 reviews     Review now
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            Augmentations of glucose uptake and glucose transporter-1 in macrophages following thermal injury and sepsis in mice.

            Nicole A. Hofmann, Sheng Liu, L He … (1996)
            Glucose is the primary metabolic substrate of macrophages, which are critical components of the host response to injury and infection. We have carried out a series of studies to examine macrophage glucose uptake and the status of glucose transporter 1 (GLUT1) at both the mRNA and protein level. Peritoneal macrophages that were obtained from mice undergoing sham burned (S), 15%TBSA burn (B) +/- Pseudomonas aeruginosa burn infection (B + I) and lipopolysaccharide (LPS) or tumor necrosis factor-alpha (TNF-alpha) administration. [3H]deoxyglucose uptake was significantly increased (B, 157 +/- 9%; B + I, 243 +/- 19%; S + LPS, 231 +/- 24%; S + TNF-alpha, 379 +/- 18%; B + LPS, 230 +/- 13%; and B + TNF, 305 +/- 23%, P< 0.01 vs. sham). GLUT1 mRNA and protein levels were increased as well (mRNA: B, 135 +/- 13%; B + I, 250 +/- 33%; S + LPS, 282 +/- 29%; S + TNF-alpha, 193 +/- 19%; B + LPS, 378 +/- 20%; and B + TNF-alpha, 204 +/- 16%; protein: B, 159 +/- 27%; B + I, 181 +/- 17%; S + LPS, 219 +/- 26%; S + TNF-alpha, 343 +/- 51%; B + LPS, 366 +/- 41%; and B + TNF-alpha, 415 +/- 44, P< 0.01 vs. sham). Macrophages co-cultured with LPS or TNF-alpha in vitro demonstrated a similar response pattern. Following burn injury and infection, macrophages augment their cellular glucose uptake, which is facilitated by an increased GLUT1 mRNA and protein levels. TNF-alpha elicited by LPS may mediate this enhanced carbohydrate metabolism at the point of glucose entry into the cell.
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              FDG-PET/CT and parathyroid carcinoma: Review of literature and illustrative case series.

              G Saladini, Nadia Sorgato, Gianmaria Pennelli … (2011)
              Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis. The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment. The role of positron emission tomography/computed tomography (PET/CT) with 18F-Fluorodeoxyglucose (18F-FDG) as an imaging tool in parathyroid cancer is not clearly reported in the literature, although its impact in other cancers is well-defined. The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer. We describe five patients with parathyroid malignant lesions, who underwent FDG PET/CT at initial staging, restaging and post-surgery evaluation. In each patient we report the value of PET/CT comparing its findings with other common imaging modalities (e.g., CT, planar scintigraphy with 99mTc-sestamibi, magnetic resonance imaging) thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma. We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status.
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Andreas Kjaer: Role: Academic Editor
                Journal
                Journal ID (nlm-ta): Diagnostics (Basel)
                Journal ID (iso-abbrev): Diagnostics (Basel)
                Journal ID (publisher-id): diagnostics
                Title: Diagnostics
                Publisher: MDPI
                ISSN (Electronic): 2075-4418
                Publication date (Electronic): 09 July 2015
                Publication date Collection: September 2015
                Volume: 5
                Issue: 3
                Pages: 290-293
                Affiliations
                Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9—PET 3982, DK-2100 Copenhagen, Denmark; E-Mail: Elisabeth.Albrecht-Beste@ 123456regionh.dk
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: kim.francis.andersen.01@ 123456regionh.dk ; Tel.: +45-3-545-7068; Fax: +45-3-545-3898.
                Article
                Publisher ID: diagnostics-05-00290
                DOI: 10.3390/diagnostics5030290
                PMC ID: 4665606
                PubMed ID: 26854155
                SO-VID: 128ed9e7-1256-4768-b718-4be314a12d5a
                Copyright © © 2015 by the authors; licensee MDPI, Basel, Switzerland.
                License:

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 23 June 2015
                Date accepted : 06 July 2015
                Categories
                Subject: Interesting Images

                Keywords: brown tumors,parathyroid carcinoma,fdg pet,primary hyperparathyroidism
                Data availability:
                Keywords: brown tumors, parathyroid carcinoma, fdg pet, primary hyperparathyroidism

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