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The Super-scan and Flare Phenomena in a Nasopharyngeal Cancer Patient: A Case Report.

Lu MC, Chuang TL, Lee MS, Chiou WY, Lin HY, Hung SK - J Clin Med Res (2012)

Bottom Line: Bone scan revealed diffuse skeletal metastases with superscan appearance.The bone scan flare phenomenon appeared within a short time after radiotherapy.Diffuse bone metastasis, which is common in NPC, were indeterminate on images showing superscan pattern or flare.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.

ABSTRACT
A 26-year-old man with a history of nasopharyngeal carcinoma (NPC) presented with bone metastasis. Bone scan revealed diffuse skeletal metastases with superscan appearance. Afterward, radiotherapy for bone lesions was arranged and the effects were evaluated. The bone scan flare phenomenon appeared within a short time after radiotherapy. Diffuse bone metastasis, which is common in NPC, were indeterminate on images showing superscan pattern or flare.

No MeSH data available.


Related in: MedlinePlus

Bone scan image reveals diffuse and increased uptake before radiotherapy.
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Figure 1: Bone scan image reveals diffuse and increased uptake before radiotherapy.

Mentions: A 26-year-old man was diagnosed with malignant NPC, which, after treatment, metastasized to bone. At the beginning, he received full cycles of chemotherapy and radiotherapy. At his regular follow up, back pain was noted after definitive treatment for 3 months. So we further investigated the progression of his disease by bone scanning. The bone scan revealed diffuse increased tracer uptake throughout the skeleton (Fig. 1). Because diffuse metastases were highly suspected and superscan pattern was revealed, we also arranged MRI of the spine to confirm the presence of bone lesions. Diffuse bony metastases were detected. With disease progression, back pain was exacerbated and poorly controlled by pain killer medications. Localized radiation treatment (300 cGy in 10 fractions) to vertebrae T5, T6, T10, and the lower portion of T9, and 3 months after radiotherapy, a bone scan to detect the effects, were arranged. However, increased diffuse activity indicating diffuse metastases was still present (Fig. 2). Examination by 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to determine the extent of metastatic spread demonstrated multiple bony metastatic lesions and enhanced uptake in the skull, entire spine, rib cage, pelvic bones, and humeral and femoral shafts. Additionally, the PET scan also revealed “cold” lesions in areas which had received radiotherapy (Fig. 3).


The Super-scan and Flare Phenomena in a Nasopharyngeal Cancer Patient: A Case Report.

Lu MC, Chuang TL, Lee MS, Chiou WY, Lin HY, Hung SK - J Clin Med Res (2012)

Bone scan image reveals diffuse and increased uptake before radiotherapy.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3376883&req=5

Figure 1: Bone scan image reveals diffuse and increased uptake before radiotherapy.
Mentions: A 26-year-old man was diagnosed with malignant NPC, which, after treatment, metastasized to bone. At the beginning, he received full cycles of chemotherapy and radiotherapy. At his regular follow up, back pain was noted after definitive treatment for 3 months. So we further investigated the progression of his disease by bone scanning. The bone scan revealed diffuse increased tracer uptake throughout the skeleton (Fig. 1). Because diffuse metastases were highly suspected and superscan pattern was revealed, we also arranged MRI of the spine to confirm the presence of bone lesions. Diffuse bony metastases were detected. With disease progression, back pain was exacerbated and poorly controlled by pain killer medications. Localized radiation treatment (300 cGy in 10 fractions) to vertebrae T5, T6, T10, and the lower portion of T9, and 3 months after radiotherapy, a bone scan to detect the effects, were arranged. However, increased diffuse activity indicating diffuse metastases was still present (Fig. 2). Examination by 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to determine the extent of metastatic spread demonstrated multiple bony metastatic lesions and enhanced uptake in the skull, entire spine, rib cage, pelvic bones, and humeral and femoral shafts. Additionally, the PET scan also revealed “cold” lesions in areas which had received radiotherapy (Fig. 3).

Bottom Line: Bone scan revealed diffuse skeletal metastases with superscan appearance.The bone scan flare phenomenon appeared within a short time after radiotherapy.Diffuse bone metastasis, which is common in NPC, were indeterminate on images showing superscan pattern or flare.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.

ABSTRACT
A 26-year-old man with a history of nasopharyngeal carcinoma (NPC) presented with bone metastasis. Bone scan revealed diffuse skeletal metastases with superscan appearance. Afterward, radiotherapy for bone lesions was arranged and the effects were evaluated. The bone scan flare phenomenon appeared within a short time after radiotherapy. Diffuse bone metastasis, which is common in NPC, were indeterminate on images showing superscan pattern or flare.

No MeSH data available.


Related in: MedlinePlus