Skeletal Bone Scintigraphy Research Articles

Радионуклидная диагностика в определении сопутствующей патологии у онкологических больных

The aim of this study is to demonstrate the significance and necessity of radionuclide diagnostics of oncologic pathology of different nature on the instance of a clinical case of detection of multiple foci of secondary nature (mts) of parathyroid gland tumor by skeletal bone scintigraphy in the course of routine examination of a patient for breast cancer. The data from the medical records, protocols and radiation methods of examination of the patient were used as the study material. During a routine examination for metastases of breast cancer through radionuclide examination of the parathyroid glands and scintigraphic examination of the skeletal bones, pathologic foci of radiopharmaceutical (RP) hyperfixation were detected in the patient. On further computed tomography (CT) of the knee joints it was found that the picture may correspond to multiple secondary lesions of the skeletal bones on the background of parathyroid gland disease. After a week the patient underwent a biphasic radionuclide study of the parathyroid glands, which made it possible to assess the presence of obvious scintigraphic signs of hyperfunctioning adenoma of the left lower parathyroid gland. Further, a thyroid gland (TG) tissue biopsy study was performed, which showed that the tissue fragment on the section was light brown with the presence of a cyst filled with brown fluid, which may correspond to a brown tumor. Thus, a patient with main breast disease is likely to be diagnosed with other unrelated cancers. The key diagnostic method in this case will be a scintigraphic study with single photon emission computed tomography (SPECT), which provides the most accurate visualization of pathology, its description and prediction of further therapy both in outpatient and inpatient settings. For the majority of cancer patients it is advisable to conduct regular examination with the help of scintigraphy for the purpose of prevention and early detection of concomitant pathology.

Merkel cell carcinoma: a case report

Merkel cell carcinoma is a rare and aggressive cutaneous neuroendocrine malignancy that presents as a persistent red-purplish, asymptomatic and rapidly growing nodule. It typically affects sun-exposed skin of white elderly individuals. In addition, risk factors for Merkel cell carcinoma include immunosuppression, as well as the presence of multiple myeloma or a history of chronic lymphocytic leukemia.
 To diagnose Merkel cell carcinoma, five criteria of the AEIOU algorithm proposed in 2008 by a group of scientists at the University of Washington are used.
 From the methods of laboratory diagnostics a detailed analysis of blood is used, also a histological and immunohistochemical study is carried out . Among the methods of instrumental diagnostics, ultrasound examination of the primary tumor and groups of lymph nodes of the appropriate localization, abdominal and pelvic organs; chest X-ray and skeletal bone scintigraphy; positron emission tomography combined with X-ray computed tomography are mandatory. A sentinel node biopsy followed by histological and immunohistochemical examination is recommended in the absence of metastatic lymph node lesions.
 We herein contribute by reporting a case of Merkel cell carcinoma affecting the forearm of a 51-year-old female. This clinical case confirms the aggressiveness of this type of the skin cancer as well as high possibility of misdiagnosis due to the scarce occurrence of Merkel cell carcinoma and lack of professional knowledge.
 Therefore, it is important for the practitioners involved in the care of skin lesions to be aware of this condition and the need for a multidisciplinary treatment approach.