Hemangioma of the rib showing a relatively high 18F-FDG uptake: a case report with a literature review

Itabashi, Takahide; Emori, Makoto; Terashima, Yoshiaki; Hasegawa, Tadashi; Shimizu, Junya; Nagoya, Satoshi; Yamashita, Toshihiko

doi:10.1177/2058460117728416

Cited by 10 publications

(10 citation statements)

References 19 publications

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“…Regarding the level of PSMA expression, most of benign lesions present lower avidity than secondary lesions do, although in a few cases some lesions may present unexpectedly high expression of PSMA. Exceptions to the rule might be found in lesions of vascular origin, such as hemangiopericytoma [45,46], angiolipoma [47] and hemangiomas [4,48,49]. PET findings may be deceptive and tricky and potentially lead to misdiagnosis.…”

Section: Benign Neoplasmsmentioning

confidence: 99%

“…The most common presentation is of nodular lesions, mostly of small dimensions, potentially encountered in multiple locations throughout the body [47,50]. Hemangiomas are especially worth highlighting, because interpretation of PSMA PET findings may be challenging since they may present intense tracer uptake [48,49,[51][52][53]. Typical imaging features include well-defined lesions with low attenuation and slow centripetal enhancement following intravenous contrast administration.…”

Section: Benign Neoplasmsmentioning

confidence: 99%

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Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings

et al. 2020

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PSMA PET imaging was originally used to assess biochemical recurrence of prostate cancer (PCa), but its clinical use was promptly extended to detection, staging and therapy response assessment. The expanding use of PSMA PET worldwide has also revealed PSMA ligand uptake in diverse nonprostatic diseases, which raised questions about the specificity of this imaging modality. Although not very common initially, a growing number of pathologies presenting PSMA uptake on PET have been reported in the last few years, and a proper interpretation of PSMA PET imaging findings suddenly became challenging and, to some extent, confusing. Compared to cytoplasmic PSMA expression in nonprostatic cells, the molecular features of apical PSMA expression in PCa cells can help to distinguish these various conditions. Correlations of imaging findings to patient history, to the expected pattern of disease spread and mainly to computed tomography (CT) and/or magnetic resonance imaging (MRI) characteristics will reinforce the distinction of lesions that are more likely related to PCa from those that could lead to an incorrect diagnosis. The overall benefits of endothelial PSMA expression, which is associated with the neovasculature of malignant neoplasms, will be highlighted, stating the potential use of PSMA ligand uptake as a theranostic tool. This review aims to cover the collection of nonprostatic diseases, including benign and malignant tumors, in a didactic approach according to disease etiology, with discussion of bone-related conditions and inflammatory and infectious processes.

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Section: Benign Neoplasmsmentioning

confidence: 99%

Section: Benign Neoplasmsmentioning

confidence: 99%

Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings

et al. 2020

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“…In the case of rib masses with septum- or honeycomb-like calcifications on CT images and marked hyperintensity on T2-weighted images, the internal enhancement observed on delayed-phase contrast-enhanced MRI is indicative of a rich fibrous stroma or vessels, which represents an important clue to suggest the diagnosis of hemangioma of the rib [ 10 ]. Although Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is useful to obtain more information about benign and malignant tumors, hemangioma of the rib showed a relatively high maximum standard uptake value (SUVmax) of 2.2–6.7 [ 4 ]. Therefore, FDG-PET may not provide useful information for distinguishing rib hemangioma from malignant tumors including chondrosarcoma.…”

Section: Discussionmentioning

confidence: 99%

Hemangioma of the Rib Mimicking Chondrosarcoma: A Report of Two Cases and Literature Review

Tsuda

Kobayashi

Makise

et al. 2021

Case Reports in Orthopedics

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Cases. Case 1 was a 58-year-old man who presented with an incidentally detected, slowly growing mass in the right hypochondrium area. An imaging study showed the mass arising from the 11th rib, with ill-defined margins and cortical destruction. Differential diagnoses included chondrosarcoma and metastatic malignant tumor. Open biopsy was associated with moderate bleeding (300 mL) despite small incision. Microscopic findings showed numerous irregular, dilated, and thin-walled vessels, consistent with the diagnosis of hemangioma of bone, and en bloc excision was performed with no surgical complication. Case 2 was a 49-year-old man who presented with an incidentally detected 4th rib mass with calcification on computed tomography scan. Chondrosarcoma was suspected according to imaging features. An open biopsy was considered to have a risk of tumor seeding because the tumor was located behind the scapula. En bloc excision of the tumor without biopsy was performed. The pathological findings were consistent with hemangioma of bone. Conclusion. We reported two cases of rare hemangioma arising from the rib, which mimicked chondrosarcoma. The preoperative diagnosis was challenging, both clinically and radiologically. Because biopsy for hemangioma of the rib is associated with a bleeding risk, the en bloc excision without biopsy can be a practical treatment option.

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“… 6 , 7 There are several reports of high FDG accumulation of the vertebral hemangiomas. 8 , 9 To our knowledge, only one report showed high uptakes of FDG in EHs of skeletal lesions. 10 The FDG uptake in EH can be caused by its characteristics of high cellularity and local aggression.…”

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confidence: 92%

Epithelioid Hemangioma of Vertebra Mimicking Metastasis on FDG PET/CT in a Patient With Renal Cell Cancer

Yanagisawa¹,

Amano²,

Omori³

et al. 2020

Clin Nucl Med

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Vertebral epithelioid hemangioma is a rare vascular tumor composed of the many vessels lined by distinct epithelioid endothelial cells. We present the case of a patient with renal cell cancer (RCC) and suspicious vertebral metastasis presenting with back pain, who was later found to have epithelioid hemangioma. FDG PET/CT demonstrated uptake of FDG not only in RCC, but also in the sixth thoracic vertebral body. The SUVmax of the vertebra was more than twice as high as RCC. This report indicates importance of quantitative assessment of FDG uptake, as well as combined use of MRI.

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Hemangioma of the rib showing a relatively high 18F-FDG uptake: a case report with a literature review

Cited by 10 publications

References 19 publications

Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings

Nonprostatic diseases on PSMA PET imaging: a spectrum of benign and malignant findings

Hemangioma of the Rib Mimicking Chondrosarcoma: A Report of Two Cases and Literature Review

Epithelioid Hemangioma of Vertebra Mimicking Metastasis on FDG PET/CT in a Patient With Renal Cell Cancer

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