Role of technetium-99m pertechnetate scintigraphy in the management of extra-abdominal fibromatosis

Abstract

The purpose of this study was to investigate technetium-99m pertechnetate (Tc-99m) as a tumorscanning agent in patients with extra-abdominal fibromatosis, and to establish the sensitivity of this type of scintigraphy. Eleven patients with extra-abdominal fibromatosis were studied: all but one having postsurgical recurrences. Of the 11 patients, diagnosed histologically, 5 underwent repeated Tc-99m scintigraphic follow-up examinations. The injected 370 MBq Tc-99m gave us an early scintigram within 10 min and a delayed one 2 h later. For adequate comparison, the region of interest (ROI) of the scintigram was placed over the tumor. The tumor-to-background (T/BG) count ratio was computed. Extra-abdominal fibromatoses, even recurrences, were demonstrated scintigraphically in both the early and the delayed phase, in all 11 patients. The average T/BG ratio was 2.11 in the early scintigram and 2.15 in the delayed one. The sensitivity and the specificity were both 100%. Tc-99m scintigraphy has proved useful in detecting extra-abdominal fibromatoses and in the follow-up of patients.

Imaging Features of Superficial and Deep Fibromatoses in the Adult Population

“…Bone involvement (Figure 6) is noted in 6% to 37% of cases [44, 45] and is more common after multiple recurrences [37]. …”

Imaging of superficial and deep fibromatosis

“…5a). Le sedi preferenzialmente colpite sono gli arti superiori o inferiori, il collo, la spalla e la parete toracica [23,24,32,33,[38][39][40][41][42][43][44][45][46]. In molti casi si manifesta come lesione unica, però è possibile osservare localizzazioni multiple e sincrone nel 10%-15% dei casi [24,40,47].…”

“…Prognosis is related to age at onset. In patients <30 years, the lesions tend to be more aggressive, with a high rate of local recurrence (>87%) [40,41,44]. Given the contiguity of this form of fibromatosis with bony structures, CT in combination with radiography is helpful for identifying any signs of bone involvement.…”

“…Often, multiple minute calcifications can be seen within the lesion. è più elevata (superiore al 87%) [40,41,44]. Per i rapporti di contiguità che questa forma di fibromatosi ha con le strutture ossee, l'esame TC è di ausilio, in associazione con l'esame radiografico, per identificare eventuali segni di coinvolgimento osseo.…”