Paravertebral Infection (Phlegmon) Demonstrated by FDG Dual-Head Coincidence Imaging in a Patient With Multiple Malignancies

A 66-year-old woman was referred for a bone scan to assess back pain on a background of breast cancer, melanoma, and rheumatic heart disease. The scan appearance was suspicious for a localized soft tissue neoplasm. An FDG coincidence positron emission tomography (PET) study demonstrated a large FDG-...

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Bibliographic Details
Published in:Clinical nuclear medicine 2005-04, Vol.30 (4), p.241-243
Main Authors: Nguyen, Quyen H, Szeto, Edwin, Mansberg, Robert, Mansberg, Victor
Format: Article
Language:English
Subjects:
Aged
Back Pain - diagnosis
Back Pain - etiology
Breast Neoplasms - complications
Breast Neoplasms - diagnostic imaging
Cellulitis - complications
Cellulitis - diagnostic imaging
Diagnosis, Differential
Diagnostic Errors - prevention & control
Female
Fluorodeoxyglucose F18
Gamma Cameras
Humans
Lumbar Vertebrae - diagnostic imaging
Melanoma - complications
Melanoma - diagnostic imaging
Radionuclide Imaging
Radiopharmaceuticals
Soft Tissue Neoplasms - complications
Soft Tissue Neoplasms - diagnostic imaging
Staphylococcal Infections - complications
Staphylococcal Infections - diagnostic imaging
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Summary:A 66-year-old woman was referred for a bone scan to assess back pain on a background of breast cancer, melanoma, and rheumatic heart disease. The scan appearance was suspicious for a localized soft tissue neoplasm. An FDG coincidence positron emission tomography (PET) study demonstrated a large FDG-avid soft tissue abnormality. Staphylococcus aureus was isolated from a subsequent needle biopsy. This case illustrates the use of FDG-PET in infection imaging, as well as demonstrating the potential pitfalls in nuclear oncology. Because FDG is not tumor-specific, accumulation in benign lesions may give rise to false-positive results despite a high pretest probability for malignancy.
ISSN:0363-9762
1536-0229
DOI:10.1097/01.rlu.0000156080.11877.b9