title: [Case of renal cell carcinoma with intertrabecular vertebral metastases detected f-18 fluorodeoxyglucose positron emission tomography and MRI].
abstract: We report a case of renal cell carcinoma with intertrabecular vertebral metastases detected by F-18 fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) and magnetic resonance imaging (MRI). The patient was a 40-year-old female, referred to our hospital for fever of ＞ 38°C, and loss of body weight. Examination showed anemia and elevated C-reactive protein (CRP). Abdominal enchanced CT showed a mass 3 cm in diameter, located on left kidney. She was diagnosed with left renal cell carcinoma (cT1aN0M0). Laparoscopic radical nephrectomy with a transabdominal approach was performed. Histological findings showed clear cell renal cell carcinoma G2＞G3. Although after operation, she presented with fever of ＞38°C, anemia, and elevated CRP and alkaline phosphatase. Systemic bone scan could not detect any bone metastases, but FDG-PET/CT and lumber MRI revealed cancer invasion to the bone of the whole body. Histological findings at bone biopsy showed clear cell carcinoma infiltrating the marrow space. We diagnosed the case as bone metastases of intertrabecular vertebral type. She was treated with temsirolimus,but died about five months after her first visit. Intertrabecular vertebral metastases that infiltrate the marrow space without trabecular bone alteration are not visible on radiographs or bone scans. FDG-PET/CT and MRI are more useful for diagnosis of intertrabecular vertebral metastases such as in this case.
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Shuko
authors.initials: S
authors.lastname: Yoneyama
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yumura
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Koizumi
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hanai
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ishida
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hattori
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Jyunichi
authors.initials: J
authors.lastname: Teranishi
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Miyoshi
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kondo
authors.affiliation: The Department of Urology and Renal Transplantation, Yokohama City University Medical Center.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Noguchi
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D010535:Laparoscopy; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009392:Nephrectomy; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary*
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein