Low-grade chondrosarcomas: a difficult target for radionuclide imaging. Case report and review of the literature.
Bone scan with Tc-99m (technetium) diphosphonate is sensitive, but non-specific for musculoskeletal tumors. Tl-201 (thallium), Tc-99m-sestamibi, Tc-99m-tetrofosmin, and F-18-fluorodeoxyglucose (F-18-FDG) can visualize tumors more specifically and are therefore useful in orthopedic oncology. However, cartilaginous tumors are characterized by histological and biological features, which potentially impair specific radionuclide imaging. A case of a patient with a low-grade primary chondrosarcoma of the femur and a false negative Tl-201 scan is presented. Tc-99m-based tumor-localizing compounds (sestamibi, tetrofosmin), as well as metabolic and receptor-imaging radiopharmaceuticals have also been reported to fail in low-grade chondrosarcomas imaging. Low cellularity, mitochondrial specialization and the presence of an efflux membrane pump may contribute to poor imaging. A negative Tl-201 or Tc-99m-sestamibi scan should be interpreted with caution, when the possibility of a chondrosarcoma is not negligible.
Arsos
Georgios
G
Department of Nuclear Medicine, Aristotle University Medical School, Hippocration Hospital, Thessaloniki, Greece. garsos@med.auth.gr
Venizelos
Ioannis
I
Karatzas
Nikolaos
N
Koukoulidis
Apostolos
A
Karakatsanis
Constantinos
C
D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging; D002813:Chondrosarcoma / Q000000981:diagnostic imaging*; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; C078700:technetium tc-99m tetrofosmin; D017256:Technetium Tc 99m Sestamibi