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LETTER TO EDITOR
Year : 2016  |  Volume : 31  |  Issue : 4  |  Page : 319  

A rare site of hyoid bone metastasis in patients with renal cell carcinoma on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scan


Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication19-Sep-2016

Correspondence Address:
Rakesh Kumar
Department of Nuclear Medicine, Diagnostic Nuclear Medicine Division, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.190806

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How to cite this article:
Passah A, Agarwal KK, ArunRaj ST, Kumar R, Bal C. A rare site of hyoid bone metastasis in patients with renal cell carcinoma on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scan. Indian J Nucl Med 2016;31:319

How to cite this URL:
Passah A, Agarwal KK, ArunRaj ST, Kumar R, Bal C. A rare site of hyoid bone metastasis in patients with renal cell carcinoma on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scan. Indian J Nucl Med [serial online] 2016 [cited 2019 Jul 23];31:319. Available from: http://www.ijnm.in/text.asp?2016/31/4/319/190806



Sir,

A 55-year-old man presented with histopathologically proven clear cell type of renal cell carcinoma (RCC). He underwent the right radical nephrectomy and received radiotherapy to bilateral pelvic bones, right femur, D7–D9 vertebrae, and right scapulae. He was on sunitinib therapy and came to our department for 18 F-fludeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) scan for restaging. In the maximum intensity projection image [Figure 1]a, it showed recurrence in the right renal bed and metastases to bilateral lungs and multiple skeletal sites including a rare site of hyoid bone metastases (black arrow). Transaxial PET/CT and CT images [Figure 1]b and [Figure 1]c showed lytic lesion in hyoid bone with increased tracer uptake (white arrow), suggestive of hyoid bone metastasis.
Figure 1: In the maximum intensity projection image (a), it showed recurrence in the right renal bed and metastases to bilateral lungs and multiple skeletal sites including a rare site of hyoid bone metastasis (black arrow). Transaxial positron emission tomography/computed tomography and computed tomography images (b and c) showed lytic lesion in hyoid bone with increased tracer uptake (white arrow), suggestive of hyoid bone metastasis

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FDG-PET/CT is useful for the restaging of patients with RCC. PET has a diagnostic accuracy of 89% for the restaging of RCC.[1] It has a diagnostic accuracy of 84% for classifying biopsy proven anatomic lesions as malignant or benign.[1] However, it has a high false-positive rate for the initial detection of primary RCC due to the presence of physiological excretion of FDG in the kidneys.[2] Postnephrectomy, many patients show recurrence. The most common sites for recurrence of RCC include lung, regional lymph nodes, bone, liver, and brain.[3] For the detection of skeletal metastases, FDG-PET/CT and bone scans have been compared. The sensitivity and specificity of FDG-PET/CT were 100% whereas the sensitivity of bone scan was 77.5% and specificity was 59.6%.[4]

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   References Top

1.
Safaei A, Figlin R, Hoh CK, Silverman DH, Seltzer M, Phelps ME, et al. The usefulness of F-18 deoxyglucose whole-body positron emission tomography (PET) for re-staging of renal cell cancer. Clin Nephrol 2002;57:56-62.  Back to cited text no. 1
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2.
Kang DE, White RL Jr., Zuger JH, Sasser HC, Teigland CM. Clinical use of fluorodeoxyglucose F 18 positron emission tomography for detection of renal cell carcinoma. J Urol 2004;171:1806-9.  Back to cited text no. 2
    
3.
Flanigan RC, Campbell SC, Clark JI, Picken MM. Metastatic renal cell carcinoma. Curr Treat Options Oncol 2003;4:385-90.  Back to cited text no. 3
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4.
Wu HC, Yen RF, Shen YY, Kao CH, Lin CC, Lee CC. Comparing whole body 18F-2-deoxyglucose positron emission tomography and technetium-99m methylene diphosphate bone scan to detect bone metastases in patients with renal cell carcinomas – A preliminary report. J Cancer Res Clin Oncol 2002;128:503-6.  Back to cited text no. 4
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