Increased bone mineral turnover without increased glucose utilization in sclerotic and hyperplastic change in fibrous dysplasia

Abstract

Fibrous dysplasia is a benign bone disorder. It is diagnosed by distinctive X-ray radiography, CT, and MRI findings. Although bone scintigraphy helps to identify the tumor origin according to accelerated bone turnover, the glucose metabolism in fibrous dysplasia has not yet been investigated. We reported a case of fibrous dysplasia in craniofacial bone which showed signs of the acceleration of bone mineral turnover without elevated glucose utilization by Technetium-99m-HMDP SPECT and Fluorine-18-FDG PET. We concluded that the growth of fibrous dysplasia needed the acceleration of bone mineral turnover without an increase in glucose metabolism.

Fibrous Dysplasia of the Clivus

“…Consequently, differential diagnostic possibilities above mentioned could easily be excluded by radiographic characteristics observed in the present case, the "ground-glass" appearance on CT scan and hypointensity in T1-and T2-weighted MR imaging. Unusually, foci of actively proliferating and growing portion within the lesion 22,23) , as clearly depicted on our PET-CT scanning, might be responsible for iso-or hyperintensity on T2 MR sequence.…”

False Positive FDG PET/CT Resulting from Fibrous Dysplasia of the Bone in the Work-Up of a Patient with Bladder Cancer: Case Report and Review of the Literature

“…These findings may change the stage of the cancer as in our case. Toba et al concluded that the growth of FDB lesions needed the acceleration of bone mineral turnover without an increase in glucose metabolism (7). Charest et al reported a patient with synchronous liposarcoma and a monostotic FDB lesion; the SUV max of the monostotic lesion (proved by biopsy) was higher (8).…”

Unexpected finding of elevated glucose uptake in fibrous dysplasia mimicking malignancy: contradicting metabolism and morphology in combined PET/CT

“…To our knowledge, no systematic studies have been published to date that assess glucose uptake with positron emission tomography (PET) and the radioactively labelled glucose derivative 18 F-fluoro-deoxyglucose (FDG) in fibrous dysplasia. However, it has been reported that single cases of fibrous dysplasia did not show an elevated FDG uptake [9,10]. These reports imply that the lack of FDG uptake in fibrous dysplasia lesions enables the identification of glucose avid bone metastases or osseous lymphoma in patients with polyostotic fibrous dysplasia and inconclusive bone scintigraphy.…”