[Bone metastasis versus insufficiency fractures due to pelvic radiotherapy for gynecologic neoplasm].
Five cases of patients with gynecological neoplasm (four cervix carcinoma and one endometrial sarcoma) who underwent pelvic external radiotherapy and intracavitary brachytherapy in whom pathologic pelvic uptake was found in the bone scan are presented. The diagnosis was pelvic insufficiency fractures due to radiotherapy adverse effects on the skeletal system confirmed by CT and by the favorable scintigraphy and clinical outcome. Both bone metastases and insufficiency fractures must be considered in the differential diagnosis of bone pain in irradiated pelvises. The bone scintigraphy detects these insufficiency fractures early and can show a typical symmetric uptake pattern. In asymmetric lesions, the CT and clinical follow-up as well as the scintigraphic evolution of the lesions should confirm the findings of the bone scintigraphies.
Martínez Caballero
A
A
Servicio de Medicina Nuclear, Hospital Clínico Universitario San Juan, Alicante, Valencia, 03550, España.
Moreno Yubero
A
A
Caballero Carpena
O
O
Serrano Vicente
J
J
Verdú Rico
J
J
Navarro Navarro
M
M
Antón Leal
M
M
Crespo Martínez
C
C
Clemente Quiles
J
J
D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D001862:Bone Resorption / Q000209:etiology; D001918:Brachytherapy / Q000009:adverse effects*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary*; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000532:radiotherapy*; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D010006:Osteoblasts / Q000528:radiation effects; D010384:Pelvic Bones / Q000000981:diagnostic imaging* / Q000473:pathology / Q000528:radiation effects; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D011867:Radioisotope Teletherapy / Q000009:adverse effects*; D011877:Radionuclide Imaging; D012447:Sacrum / Q000000981:diagnostic imaging* / Q000473:pathology / Q000528:radiation effects; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*