technetium-tc-99m-medronate and Mediastinal-Neoplasms

Soft tissue giant cell tumor (GCT) is rare. It usually involves the extremities. We report the case of a 37-year-old woman who was suspected of having mediastinal tumor on radiograph. Thoracic CT revealed the tumor had extensive calcification and invaded the adjacent vertebrae and spinal canal. It intensively accumulated Tc-methylene diphosphonate on bone scan. The tumor showed hypointensity on T1-weighted and mixed intensity on T2-weighted fat-saturated sagittal images. Finally, a soft tissue GCT was confirmed by pathology. The case cautions us soft tissue GCT should be in the differential diagnosis spectrum in a calcified posterior mediastinal mass with Tc-methylene diphosphonate accumulation.

Topics: Adult; Diagnosis, Differential; Female; Giant Cell Tumors; Humans; Mediastinal Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed

A 41-year-old woman presented with cough and shortness of breath for 3 weeks. Chest x-ray and CT showed a large, partially calcified soft tissue mass adjacent to the right side of the heart. Whole-body bone was acquired to evaluate possible metastases, which showed abnormal accumulation of Tc-MDP in the right chest. Further SPECT/CT imaging that demonstrated intense Tc-MDP activity was mainly in the calcification portion of mass. Histopathological examination from biopsy specimen of the lesion was consistent with malignant teratoma.

Topics: Adult; Calcinosis; Female; Humans; Mediastinal Neoplasms; Multimodal Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Teratoma; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Neuroblastoma is the third most common malignancy of childhood. 131I-MIBG scintigraphy must be performed in patients with neuroblastoma at the time of staging. The aim of this study is to identify the role of 131I-MIBG scintigraphy in neuroblastoma patients in correlation with other diagnostic modalities for staging of the disease.. Twenty six patients provisionally diagnosed by clinical and imaging criteria to have neuroblastoma were included. On histopathologic verification 5 of these 26 patients were rediagnosed as non-neuroblastoma. Each patient had imaging by ultrasound, CT and/or MRI. In all cases, 131I-MIBG scintigraphy was performed, among them 15 patients had additional 99mTc-MDP bone scan.. The outcome demonstrated that CT and MRI were able to detect lesions in 19 out of 21 patients; while in 2 patients no lesions were detected. 131I-MIBG showed active lesions in 16 out of the above 19 patients, while in 3 patients 131I-MIBG was negative. There were no false positive result by 131I-MBG scan. Accordingly, 131I-MIBG is able to detect neuroblastora lesions with an overall sensitivity of 84.2%, specificity of 100% and an accuracy of 85.7%. Detection of primary lesions by 131I-MIB was significantly better than 99mTc-MDP bone scanning (92.31% vs. 61.54% respectively) (P < 0.05). For skeletal metastases, 131I-MIBG scan has a higher ability to detect more lesions than 99mTc-MDP bone scan (P = 0.023).. 131I-MIBG scintigraphy has an excellent ability to discriminate between neuroblastonia and other small round cell paediatric tumours. 131I-MIBG was found to be significantly superior to conventional bone scanning in revealing both primary and metastatic osseous lesions.

Topics: 3-Iodobenzylguanidine; Adolescent; Adrenal Gland Neoplasms; Bone Marrow Neoplasms; Brain Neoplasms; Child; Child, Preschool; Female; Humans; Infant; Iodine Radioisotopes; Liver Neoplasms; Male; Mediastinal Neoplasms; Neoplasm Staging; Neuroblastoma; Radionuclide Imaging; Radiopharmaceuticals; Retroperitoneal Neoplasms; Spinal Neoplasms; Technetium Tc 99m Medronate

Non-Hodgkin lymphoma (NHL) is rare in infancy, and we present a case of aggressive NHL of T-cell lineage in an infant with multifocal bone, cardiac, mediastinal nodal, paranasal sinus, calvarial, and soft-tissue deposits on presentation that were detected on whole-body MRI.

Topics: Bone Neoplasms; Heart Neoplasms; Humans; Infant; Lymph Nodes; Lymphoma, T-Cell; Magnetic Resonance Imaging; Male; Mediastinal Neoplasms; Paranasal Sinus Neoplasms; Radiopharmaceuticals; Skull Base Neoplasms; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Whole Body Imaging

Tc-99m sestamibi, originally developed for myocardial studies, has been used as a tumor-seeking agent. Recently, the agent also was reported to be a functional tracer to predict multidrug resistance-related p-glycoprotein expression in tumor tissue. The current report presents the authors' experience with sestamibi tumor scintigraphy in a neuroblastoma. Although I-131 MIBG tumor imaging and Tc-99m MDP bone scanning accurately demonstrated the extent of the disease, Tc-99m sestamibi showed no accumulation in primary and metastatic foci. Lack of sestamibi uptake was initially thought to be suggestive of failure to respond to chemotherapy because of p-glycoprotein expression. However, the patient responded well to chemotherapy and complete remission was achieved. The failure of Tc-99m sestamibi to detect a neuroblastoma and the lack of sestamibi accumulation in the tumor may not always be related to chemotherapy resistance.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Child, Preschool; Drug Resistance, Neoplasm; False Negative Reactions; Gene Expression Regulation, Neoplastic; GTP-Binding Proteins; Humans; Male; Mediastinal Neoplasms; Neoplasm Staging; Neuroblastoma; Radionuclide Imaging; Radiopharmaceuticals; Remission Induction; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi

Topics: Adult; Calcinosis; Cystadenocarcinoma, Papillary; Female; Humans; Lymphatic Metastasis; Mediastinal Neoplasms; Ovarian Neoplasms; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon

Topics: Adolescent; Artifacts; Bone and Bones; Catheterization, Central Venous; Catheters, Indwelling; Female; Femoral Vein; Hodgkin Disease; Humans; Iliac Vein; Mediastinal Neoplasms; Pelvis; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

Topics: Bone and Bones; Female; Humans; Infant; Leg; Mediastinal Neoplasms; Neuroblastoma; Radionuclide Imaging; Technetium Tc 99m Medronate; Thoracic Nerves

Separate imaging studies employing Tc-99m MDP, In-111 labeled leukocytes, and Tc-99m SC were performed in a patient receiving external beam radiation therapy to the mediastinum and left hemithorax. The leukocyte scan demonstrated greatly increased activity at the site of the radiation port. The bone marrow (sulfur colloid) scan was normal and the bone scan demonstrated only minimally increased activity in the irradiated region. The varying appearance of these scans may represent the difference in the early effect of radiation on bone and bone marrow elements.

Topics: Bone Marrow; Carcinoma, Renal Cell; Humans; Indium Radioisotopes; Leukocytes; Male; Mediastinal Neoplasms; Middle Aged; Radionuclide Imaging; Radiotherapy, High-Energy; Ribs; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid; Thoracic Neoplasms; Thoracic Vertebrae

This is a report for an unusual case of oxyphilic cell adenocarcinoma originating from anterior mediastinum in a 36-year-old male who complained of his neck lymphoadenopathy. 201Tl whole body scanning showed increased uptake of the left supraclavicular and upper mediastinal regions. There was no history of prior operation nor irradiation to the thyroid or neck region. Chest CT scanning also demonstrated the tumor in the superior mediastinum, but the mass has no increased 67Ga uptake. No tumor in the thyroid lobes was apparent on thyroid scintiscanning, ultrasonography and neck CT. The mediastinal tumor resection, the right and left thyroid lobectomy and the neck lymphonodectomy were completed. Serial sectioning of the resected thyroid lobes failed to show any tumorous tissue. The light microscopic features of a Hurthle-cell tumor arising in the mediastinal ectopic thyroid and diagnosed by neck lymph node biopsy were presented. The tumor was clinically malignant, having metastasized to the bone and the neck lymph nodes. Non surgical treatment including radioactive iodine (131I) therapy and combination chemotherapy were disappointing. The patient deteriorated progressively and died 16 months after thyroidectomy. We describe here an unusual case of a papillary growing and thyroglobulin producing tumor in the superior mediastinal region without evidence of a primary thyroid gland tumor.

Topics: Adult; Bone and Bones; Carcinoma; Combined Modality Therapy; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Mediastinal Neoplasms; Mediastinum; Radionuclide Imaging; Technetium Tc 99m Medronate; Thallium

Topics: Bone Neoplasms; Child; Humans; Humerus; Mediastinal Neoplasms; Osteosarcoma; Pericardium; Radionuclide Imaging; Technetium Tc 99m Medronate

A case of unilateral nearly total hypoperfusion of the left lung in a 13-month-old girl is presented. The combination of the lung hypoperfusion and accumulation of the Tc-99m MDP and Ga-67 citrate in the same area suggested the preoperative diagnosis of mediastinal neuroblastoma. Explorative thoracotomy revealed the presence of a neuroblastoma compressing the left lung pedicle. The described scintigraphic appearance in the pediatric age group is suggested as typical of mediastinal neuroblastoma. This pathology should be included in the following gamuts in nuclear medicine: unilateral decrease or absent lung perfusion, unilateral diffuse chest uptake of Ga-67 citrate, and unilateral pulmonary uptake in bone scintigraphy.

Topics: Female; Gallium Radioisotopes; Humans; Infant; Lung; Mediastinal Neoplasms; Neuroblastoma; Perfusion; Radionuclide Imaging; Technetium Tc 99m Medronate

Two cases of retrosternal multinodular goiter are described in which 99mTc-MDP concentrated. The possible etiology of this unexpected finding is briefly discussed in addition to the differentiation from other mediastinal tumors which may potentially accumulate 99mTc-MDP.

Topics: Diagnosis, Differential; Diphosphonates; Female; Goiter; Humans; Male; Mediastinal Diseases; Mediastinal Neoplasms; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

A 2 1/2-year-old boy with a posterior mediastinal ganglioneuroblastoma was evaluated by bone scintigraphy using 99mTc-DMP and showed a marked increased uptake in the tumor mass. Although a routine chest X-ray and body CT scan failed to demonstrate calcification, X-ray examination of the removed tumor specimen revealed small scattered calcification. The proposed mechanisms of the radiopharmaceutical localization in benign and malignant tumors other than calcification/mineralization are discussed. Regardless of the mechanism, localization of a bone scanning agent in a tumor provides a rapid, simple, and noninvasive means of demonstrating tumor size, configuration, and the relation of the surrounding structures to the tumor.

Topics: Bone and Bones; Child, Preschool; Diphosphonates; Ganglioneuroma; Humans; Male; Mediastinal Neoplasms; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate

Topics: Adult; Bone and Bones; Diphosphonates; Female; Hemangioendothelioma; Humans; Lung; Mediastinal Neoplasms; Serum Albumin; Technetium; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Medronate; Tomography, Emission-Computed; Tomography, X-Ray Computed

Forty patients, ages three days to 12 years, with neuroblastomas had bone scans with 99mtechnetium methylene diphosphonate (99mTc-MDP) as part of their pretreatment examination. Twenty-four (60%) had primary tumor uptake and 16 (40%) did not. No difference was seen between the two groups in the incidence of tumor calcification or necrosis. No relationship between the level of urinary vanillylmandelic acid (VMA) and the presence of primary tumor uptake of 99mTc-MDP was found. The possible causes for the localization of 99mTc-MDP are discussed.

Topics: Adrenal Gland Neoplasms; Bone and Bones; Calcinosis; Child; Child, Preschool; Diphosphonates; Female; Humans; Infant; Infant, Newborn; Male; Mediastinal Neoplasms; Necrosis; Neuroblastoma; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Vanilmandelic Acid