technetium-tc-99m-medronate and Histiocytoma--Benign-Fibrous

We report a case of MFH of the mandible in a 16-year-old girl. The mandible is a rare location of MFH of bone, with only 21 cases described in the literature. Clinical, pathologic, and radiologic features are discussed, with special emphasis on the unusual pathologic and radiographic features.

Topics: Adolescent; Biopsy; Chronic Disease; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Humans; Mandible; Mandibular Neoplasms; Radiography, Panoramic; Radionuclide Imaging; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Topics: Aged; Bone Neoplasms; Diphosphonates; Female; Histiocytoma, Benign Fibrous; Humans; Lung Neoplasms; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Ultrasonography

The purpose of this study was to evaluate the radiographic findings of malignant fibrous histiocytoma (MFH) and to discuss the contribution of these findings to a differentiation of MFH from other malignant tumors of the head and neck.. Two cases of MFH of the maxillary sinus affecting the alveolar bone were evaluated radiographically and scintigraphically.. We reported the following findings, which have only seldom been described: the presence of fairly well-demarcated bone destruction in the intraoral radiograph; the relatively smooth surface, uniform density, or no necrotic area of the tumor; in computed tomograph images showing the clear separation of the tumor from surrounding soft tissues; bone scintigraphs reflecting the periosteal reaction to tumor invasion; and lymphoscintigraphy of the metastatic lymph nodes.. We evaluated the radiographic findings from 2 cases of MFH and describe findings that may aid in the differentiation of MFH. These radiographic features may help dentists differentiate MFH from other malignant tumors in the head and neck, although MFH is a rare disease and there are no radiographic findings that would indicate a specific diagnosis of MFH.

Topics: Alveolar Process; Citrates; Diagnosis, Differential; Female; Gallium; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Maxillary Neoplasms; Maxillary Sinus Neoplasms; Middle Aged; Neoplasm Invasiveness; Periosteum; Radiography, Panoramic; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignant tumour in late adult life. MFH has been mentioned to have avid uptake of 67Ga citrate, and only 38% is uptake of 99mTc-MDP, although few cases of MFH have been reported. We present the case of a 73 years old male patient with MFH. In the blood pool phase of the bone scintigraphy, MFH was presented as an intense hyperactive lesion. In the late phase the tumor is one of the few MFH described to have avid uptake for 99mTc-MDP. In this work we also review some cases of MFH described and the different techniques used in the diagnosis and follow-up of these tumours.

Topics: Aged; Arm; Histiocytoma, Benign Fibrous; Humans; Male; Neoplasm Invasiveness; Radionuclide Imaging; Radiopharmaceuticals; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

The aim of this study was to evaluate the value of three-phase dynamic bone scintigraphy (TPBS) in the assessment of the response of bone sarcomas to pre-operative chemotherapy and to correlate serial scintigraphic changes with histological findings. The study group comprised 27 patients (osteogenic sarcoma, n = 20; Ewing's sarcoma, n = 5; malignant fibrous histiocytoma, n = 2) with a mean age of 19.2 years. All patients received 99Tcm-methylene diphosphonate TPBS before and after pre-operative chemotherapy. Each phase of the imaging procedure was interpreted qualitatively and quantitatively. The percentage of tumour necrosis was analysed on resection materials following surgery. Histologically, 12 patients were non-responsive (tumour necrosis less than 90%) and 15 patients were responsive (tumour necrosis more than 90%). A decrease in the tumour blood flow ratio and extension were the most notable findings in the responders. The mean change in the tumour blood flow ratio following therapy was 58.7 +/- 8.3% and 19.9 +/- 26.6% (P < 0.005) in responders and non-responders respectively. The accuracy of three-phase imaging and static bone scintigraphy was 88% and 74% respectively. Since bone scintigraphy is a valuable technique owing to its ability to detect distant metastases in clinically early disease, TPBS should be helpful in monitoring therapy effects without any additional cost or radiation dose.

Topics: Adolescent; Adult; Antineoplastic Agents; Bone and Bones; Bone Neoplasms; Chemotherapy, Adjuvant; Child; Data Interpretation, Statistical; Female; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Osteosarcoma; Radiopharmaceuticals; Regional Blood Flow; Sarcoma, Ewing; Technetium Tc 99m Medronate; Tomography, Emission-Computed

We quantitatively analyzed images of 99mTc-HMDP bone scintigraphy in 34 bone sarcomas before and after preoperative chemotherapy. The isotopic uptake was calculated as tumor-to-background ratio (TBR), and the changes in TBR before and after chemotherapy were calculated as the alteration ratio. The histological effect of preoperative chemotherapy was classified in 4 grades, according to Huvos. We defined good scintigraphic responders as cases having decreased uptake after chemotherapy, with an alteration ratio > or = 60%. There was a positive correlation (Rho = 0.76, p < 0.001) between the histological effect and the alteration ratio. Of the 17 good histological responders, 13 showed a good scintigraphic response. The average alteration ratio in 17 cases with good response (68%) was higher than that in 17 cases showing poor response (-9.9%) (p < 0.001). 3 patients with pathologic fractures and 1 with primarily normal uptake showed false negative findings. The sensitivity of this method was 100% and the specificity was 81%.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Combined Modality Therapy; Female; Histiocytoma, Benign Fibrous; Humans; Image Processing, Computer-Assisted; Leg; Male; Neoadjuvant Therapy; Osteosarcoma; Radionuclide Imaging; Sarcoma; Sarcoma, Ewing; Sensitivity and Specificity; Technetium Tc 99m Medronate; Treatment Outcome

Topics: Bone Neoplasms; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Humans; Ilium; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

The purpose of this study was to evaluate the value of bone and Ga-67 imaging in patients with malignant fibrous histiocytoma (MFH). Thirty-four patients with biopsy-proven MFH were studied. Of these patients, 15 underwent Ga-67 imaging, 26 underwent Tc-99m MDP imaging, and 7 underwent both imaging procedures. In evaluation of the primary tumors, intense Ga-67 uptake was observed in 14 of 15 patients with a diagnostic sensitivity of 93.3%. However, positive bone imaging results were observed in only 10 of 26 patients with a diagnostic sensitivity of 38.5%. Most of these were secondary to Tc-99m MDP uptake in adjacent bone invaded by the primary tumor. Only two patients, of the 18 patients without direct bone invasion, had increased radioactivity in the tumors (11.1%). In evaluation of the metastatic lesions, increased Ga-67 uptake was observed in 8 of 8 metastatic sites (100%). However, Tc-99m MDP could only detect 5 of 12 metastatic sites (41.7%), which were all diagnosed to be bone metastases. None of the extraskeletal metastasis could be detected by Tc-99m MDP imaging. Ga-67 scintigraphy appears to be a very useful tool in the evaluation of both primary and metastatic lesions of MFH and is assumed to be useful in the follow-up. However, it is emphasized that bone scintigraphy is useful only when the tumor invades the skeletal system and is of limited value in the evaluation of extraskeletal lesions.

Topics: Bone and Bones; Bone Neoplasms; Evaluation Studies as Topic; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Soft Tissue Neoplasms; Technetium Tc 99m Medronate

A case of calcifying soft tissue malignant fibrous histiocytoma (MFH) which showed a concentration of Tc-99m MDP and Ga-67 citrate, is presented. Tc-99m MDP and Ga-67 citrate scintigraphies of the thigh mass were correlated with conventional radiography, computed tomography (CT) and angiography.

Topics: Aged; Citrates; Citric Acid; Female; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

The case of a patient with malignant fibrous histiocytoma is described. Emphasis is placed on the preoperative implementation of bone scintigraphy and MRI, which yielded discrepant findings. The ultimate therapeutic approach is discussed in light of the discrepancy and the conclusive pathologic result.

Topics: Adult; Histiocytoma, Benign Fibrous; Humans; Humerus; Magnetic Resonance Imaging; Male; Muscles; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

The authors retrospectively reviewed the Tc-99m medronate scan findings in six patients who had no evidence of metastatic disease following en bloc resection of a primary osteosarcoma and subsequent limb reconstruction using allograft bone. Persistently increased radionuclide uptake was noted at the junction between the host bone and the graft, while the graft cortical bone showed persistently decreased activity. Radionuclide uptake at the periphery of the graft varied. Over time the youngest patient in the series had increasingly normal scan findings.

Topics: Adolescent; Adult; Bone Neoplasms; Bone Transplantation; Child; Child, Preschool; Histiocytoma, Benign Fibrous; Humans; Leg; Osteosarcoma; Radionuclide Imaging; Retrospective Studies; Sarcoma, Ewing; Technetium Tc 99m Medronate; Time Factors

Various causes for cold defects on bone scans (e.g., avascular necrosis) have been described. A case is presented in which a cold defect on a technetium-99m-methylene diphosphonate bone scan was the result of malignant fibrous histiocytoma.

Topics: Aged; Histiocytoma, Benign Fibrous; Humans; Male; Radionuclide Imaging; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Spinal Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

We examined the roentgenographical features of 5 patients who were diagnosed histopathologically as malignant fibrous histiocytoma (MFH) of bone, especially on the imaging of bone scintigraphy. Two patients had multiple lesions on the initial examination, and two of 3 patients who showed solitary lesion on the first examination could be detected more pathological sites by bone scintigraphy which was studied within two months of the first investigation. On bone scintigraphy, the mixture of hot and cold lesions which was coincident with the osteolytic change on plan X-P could be noticed, and with the progression of osteolysis it had a tendency to increase the area of cold lesions. These features are similar to metastatic bone tumor which is the most questionable disease on diagnosis, and we conclude that bone scintigraphy will be absolutely necessary when MFH of bone is highly suspected in the clinical course.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Female; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate

A man with malignant fibrous histiocytoma of the thigh had avid uptake of Tc-99m MDP in the lesion. Review of tissue sections showed considerable accumulation of iron in the tumor. Iron is known to be a potential nidus for deposition of the Tc-99m diphosphonates. A review was made of tissue sections from two other reported cases of malignant fibrous histiocytoma which also had significant accumulation of Tc-99m diphosphonates. Both revealed iron within the tumor. The origin of the iron is unknown (perhaps from necrosis and hemorrhage, from trauma, or from innate phagocytic activity of the histiocytes). However, this observation may serve as a stimulus to studies attempting to discern the underlying mechanisms of extraosseous deposition of the Tc-99m diphosphonates.

Topics: Adult; Hemosiderin; Histiocytoma, Benign Fibrous; Humans; Male; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

Topics: Adolescent; Bone Diseases; Bone Neoplasms; Child; Child, Preschool; Eosinophilia; Follow-Up Studies; Histiocytoma, Benign Fibrous; Humans; Osteoma, Osteoid; Osteosarcoma; Radionuclide Imaging; Sarcoma, Ewing; Technetium Tc 99m Medronate

The authors describe a case of a skull infarction initially suspected to be an isolated, remote metastasis in a patient diagnosed with soft tissue malignant fibrous histiocytoma. Osseous malignant fibrous histiocytoma has been reported to occur within a bone infarction but the presence of a benign bone infarction remote from a soft tissue malignant fibrous histiocytoma has not been reported previously. Bone infarctions and malignant fibrous histiocytomas are briefly reviewed.

Topics: Adult; Histiocytoma, Benign Fibrous; Humans; Infarction; Male; Radionuclide Imaging; Skull; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

Malignant fibrous histiocytoma (MFH) is the most common soft tissue malignancy in adults. The Ga-67 citrate scan findings of an extremity-located MFH, the most common location of this neoplasm, have never been published in English language journals to the best of the authors' knowledge. Ga-67 citrate and Tc-99m MDP scans of the thigh mass accurately depicted the tumor's local extent, including the presence of central ischemic necrosis within the tumor, and the absence of adjacent osseous involvement and distant metastases, as correlated with computed tomography, angiography, and pathologic examinations.

Topics: Femur; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Radionuclide Imaging; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid which is rapidly transported into viable cells by the A-type or alanine-preferring amino acid transport system, has been labeled with the short-lived, positron-emitting radionuclide carbon-11. Carbon-11 labeled AIB is currently being evaluated as a tumor imaging agent for in vivo amino acid transport studies in patients with cancer. In this study, C-11 AIB was used to image two patients with malignant fibrous histiocytoma (MFH), a pleomorphic sarcoma. Following intravenous administration of C-11 AIB, tumors in the distal femur of one patient and in the anterior chest wall of another patient were well visualized using high energy gamma scintigraphy. Since therapy may alter the accumulation of amino acids in tumor tissue, studies using C-11 AIB in patients with MFH before and after chemotherapy are in progress.

Topics: Adult; Aminoisobutyric Acids; Carbon Radioisotopes; Female; Femoral Neoplasms; Gallium Radioisotopes; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Medronate; Thoracic Neoplasms

Topics: Adult; Aged; Carcinoma, Squamous Cell; Child, Preschool; Diphosphonates; Female; Histiocytoma, Benign Fibrous; Humans; Liposarcoma; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Radionuclide Imaging; Rectal Neoplasms; Rhabdomyosarcoma; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh