title: Q Fever masquerading as prostate cancer metastases.
abstract: We report a case of Q fever demonstrated on (99m)Tc methylene diphosphonate bone scan and fluorodeoxyglucose (FDG) PET/CT. A 66-year-old man with newly diagnosed, low-grade prostate cancer presented with abdominal and bone pain. Bone scan revealed multiple lesions suspicious for prostate cancer metastases. Because of liver abnormalities on noncontrast CT, an FDG PET/CT was performed and demonstrated FDG-avid sclerotic bone lesions, infiltrative liver disease, and retroperitoneal adenopathy. This appearance, thought unusual for low-grade prostate cancer, prompted extensive clinical evaluation for several months. Liver and iliac bone biopsies showed noncaseating granulomas without neoplasia. Extensive serologic evaluation eventually demonstrated elevated Q fever titers.
authors.affiliation: Department of Radiology, University of New Mexico, Albuquerque, NM 87131–0001, USA. mjgolden@salud.unm.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Golden
authors.forename: Joanna R
authors.initials: JR
authors.lastname: Fair
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011778:Q Fever / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18; D013669:Technetium Tc 99m Medronate