Osseous Sarcoidosis Mimicking Metastatic Cancer on Positron Emission Tomography

Ashamalla, Michael; Koutroumpakis, Efstratios; McCarthy, Lezah; Hegener, Paul; Grimm, Rachel J; Mehdi, Syed

doi:10.1200/jop.2016.012807

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Growing evidence suggests that 18F-NaF PET/CT provides increased sensitivity and specificity in bone metastases detection. However, in a previous report, 18F-NaF PET/CT failed to discern metastatic disease from osseous sarcoidosis (35).…”

Section: Imaging Featuresmentioning

confidence: 72%

Vertebral sarcoidosis: diagnosis to management

Ferjani¹,

Rahmouni²,

Nessib³

et al. 2022

Acta Orthop Belg

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Sarcoidosis is a systemic inflammatory granulomatous disease that can develop in almost any organ system. Rheumatologists may encounter sarcoidosis in different situations varying from arthralgia to bone involvement. While the peripheral skeleton was a frequent location, data regarding axial involvement is scarce. Most patients with vertebral involvement have a known diagnosis of intrathoracic sarcoidosis. They tend to report mechanical pain or tenderness over the involved area. Imaging modalities, particularly Magnetic Resonance Imaging (MRI), are a mainstay of axial screening. It helps exclude differential diagnoses and delineate the extent of bone involvement. Histological confirmation combined with the ap- propriate clinical and radiological presentation is the key of diagnosis. Corticosteroids remain the cornerstone of treatment. In refractory cases, methotrexate is the steroid- sparing agent of choice. Biologic therapies may be used, although the evidence base for their efficacy is bone sarcoidosis controversial.

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Section: Imaging Featuresmentioning

confidence: 72%

Vertebral sarcoidosis: diagnosis to management

Ferjani¹,

Rahmouni²,

Nessib³

et al. 2022

Acta Orthop Belg

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“…Improvement following treatment, e.g., with corticosteroids, has been reported. In some patients, the diagnosis of sarcoidosis was pre-existing, while in other cases, suspicious findings on magnetic resonance imaging (MRI) prompted bone biopsies that lead to diagnosis [ 68 , 69 ]. The radiological findings, however, lack specificity.…”

Section: Resultsmentioning

confidence: 99%

Extravertebral low back pain: a scoping review

Kunow,

Freyer Martins Pereira,

Chenot

2024

BMC Musculoskelet Disord

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Background Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. Methods A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. Results The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. Discussion Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. Conclusion The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.

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“…Other groups have reported false positive PET scan findings can be caused by infectious diseases (including mycobacterial, fungal, or bacterial), sarcoidosis, trauma, and post-operative surgical conditions in the absence of malignancy. [9][10][11][12][13][14][15][16][17][18][19][20] In fact, a concurrent diagnosis of sarcoidosis has been described in a case report when additional lesions were identified during initial cancer staging workup, but the additional lesions were subsequently determined to be nonmalignant. 21 Other alternative nonmalignant etiologies of bone lesions include fibrous dysplasia of bone, osteonecrosis, osteitis fibrosa cystica, and Paget's disease of bone, among others, can present with PET-avid lesions on imaging and characteristic laboratory findings including hypercalcemia.…”

Section: Discussionmentioning

confidence: 99%

“…Known nonmalignant causes of FDG‐avid lesions include anything that induces inflammation or increased glucose uptake in tissue, which are commonly of infectious or autoimmune origin. Other groups have reported false positive PET scan findings can be caused by infectious diseases (including mycobacterial, fungal, or bacterial), sarcoidosis, trauma, and post‐operative surgical conditions in the absence of malignancy 9‐20 . In fact, a concurrent diagnosis of sarcoidosis has been described in a case report when additional lesions were identified during initial cancer staging workup, but the additional lesions were subsequently determined to be nonmalignant 21 .…”

Section: Discussionmentioning

confidence: 99%