technetium-tc-99m-medronate and Fibrous-Dysplasia--Monostotic

The rare coexistence of intramuscular myxoma (IM) and fibrous dysplasia (FD) is known as Mazabraud's syndrome. IM tends to occur multifocally and is associated most frequently with polyostotic FD in Mazabraud's syndrome. We present an extremely rare combination of a solitary IM and monostotic FD as a variant of Mazabraud's syndrome, and discuss the importance of recognizing this rare coexistence for appropriate management of the patient.

Topics: Biopsy; Contrast Media; Diagnosis, Differential; Female; Fibrous Dysplasia, Monostotic; Gadolinium DTPA; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Muscle Neoplasms; Myxoma; Radiopharmaceuticals; Syndrome; Technetium Tc 99m Medronate; Thigh; Tomography, Emission-Computed; Tomography, X-Ray Computed

Topics: Adult; Fibrous Dysplasia, Monostotic; Humans; Male; Multimodal Imaging; Radiopharmaceuticals; Ribs; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

A 22-year-old woman had a Tc-99m MDP whole-body scan for low back pain. A focal area of increased activity was seen in the skull base in the region of the sella turcica. A computed tomographic examination showed ground-glass opacification of the sphenoid sinus and bony sclerosis along its walls, characteristic of fibrous dysplasia. Monostotic fibrous dysplasia, the more common form compared with the polyostotic variety, occurs in 70% to 80% of all patients with fibrous dysplasia. Monostotic lesions usually involve the ribs, femur, tibia, cranium, maxilla, and mandible. The frontal and sphenoid bones are the cranial bones most commonly involved.

Topics: Adult; Female; Fibrous Dysplasia, Monostotic; Humans; Low Back Pain; Osteosclerosis; Paranasal Sinus Diseases; Radionuclide Imaging; Radiopharmaceuticals; Sella Turcica; Skull Base; Sphenoid Sinus; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Scintigraphic manifestations of fibrous dysplasia were analyzed in 59 lesions of 26 patients (12 monostotic, 14 polystotic). Bone imaging with Tc-99m MDP revealed a high percentage of increased uptake of radioisotope in the lesions of fibrous dysplasia. Four (14%) of 29 cystic lesions and two (7%) of 30 lesions with the appearance of ground glass showed no increase in radioisotope uptake, although roentgenograms showed marked changes. Therefore, care must be taken in the diagnosis of fibrous dysplasia with bone imaging alone. Nuclear methods, however, are indispensable in evaluating the dynamic aspects of bone mineral behavior and in demonstrating disease where none was suspected, or in visualizing polyostotic involvement in those cases where only monostotic disease was suspected clinically. It is concluded that both scintigrams and roentgenograms are complementary procedures in the diagnosis of fibrous dysplasia.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Fibrous Dysplasia of Bone; Fibrous Dysplasia, Monostotic; Fibrous Dysplasia, Polyostotic; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

Topics: Diphosphonates; Fibrous Dysplasia of Bone; Fibrous Dysplasia, Monostotic; Humans; Male; Metacarpus; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate