Malignant peripheral nerve sheath tumors (MPNSTs) of bone are rare. It is mainly located in the appendicular skeleton. The lung is the most common site of metastasis. Solitary lymph node metastasis is very rare. Herein, we report the imaging findings of MPNST in the first thoracic vertebra with lymph node metastasis in the left axillary region. On FDG PET/ CT, these lesions had intense FDG uptake. This case highlights that solitary lytic thoracic vertebral lesion with intense FDG accumulation should regard MPNST as a differential diagnosis and that FDG PET/CT has an important role in the initial staging of MPNST.

BackgroundSubclinical hypothyroidism (SCH) is usually treated with levothyroxine, but there is controversy as to whether SCH should be treated, especially for older patients. The aim of the systematic review and meta-analysis was to evaluate whether levothyroxine has a beneficial or harmful effect on older patients with SCH.MethodsDatabases including PubMed, Embase, Cochrane Library, Web of Science, Wanfang, Weipu and China National Knowledge Infrastructure were searched from inception until December 21, 2021. Subjects must be diagnosed with SCH, and older than or equal to 60 years of age. Interventions should be thyroid hormone therapy (e.g. levothyroxine). The literature was independently screened by 2 researchers. Statistical analysis was performed using RevMan5.3 software.ResultsA total of 13 articles were included. Meta-analysis results showed that in older SCH patients, levothyroxine can significantly reduce cholesterol (TC) (p < 0.00001), triglyceride (TG) (p < 0.00001), low-density lipoprotein cholesterol (LDL-C) (p = 0.03) and apolipoprotein B (ApoB) (p < 0.00001). In addition, levothyroxine had no significant effect on bone mineral density, fatigue, hypothyroidism symptoms, quality of life, BMI, cognitive function, depression, blood pressure, etc. in older SCH patients, and also did not significantly increase the incidence of adverse events.ConclusionsAmong older SCH patients, levothyroxine treatment may reduce TC, TG, LDL-C, and ApoB.

Hamartoma of the rib is very rare in adults. Herein, we report a 49-year-old woman who complained of chest pain for 1 month. FDG PET/CT revealed focal osteolytic bone destruction in the right 11th rib with elevated FDG uptake. The postoperative pathology supported the diagnosis of hamartoma. Our case shows that hamartoma should be considered as a differential diagnosis when there is solitary osteolytic bone destruction in the rib with intense FDG uptake.

No abstract