False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant

We present a rare variant of prostate carcinoma. The patient is a 45-year-old male with elevated prostate-specific antigen levels at screening. Magnetic resonance imaging revealed hyperenhancing lesions throughout the axial skeleton. The fluorine-18 fluorocholine (FCH) positron emission tomography/c...

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Main Authors: Ammad Al-Tamimi, Andrew Tan, Sidney Kwong, Christopher Sam, Angela Chong, Cher Tan
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2012-04-01
Series:World Journal of Nuclear Medicine
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103422
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author Ammad Al-Tamimi
Andrew Tan
Sidney Kwong
Christopher Sam
Angela Chong
Cher Tan
author_facet Ammad Al-Tamimi
Andrew Tan
Sidney Kwong
Christopher Sam
Angela Chong
Cher Tan
author_sort Ammad Al-Tamimi
collection DOAJ
description We present a rare variant of prostate carcinoma. The patient is a 45-year-old male with elevated prostate-specific antigen levels at screening. Magnetic resonance imaging revealed hyperenhancing lesions throughout the axial skeleton. The fluorine-18 fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) scan showed no abnormal bone findings. Subsequently, a technetium-99 methydiphosphonate (Tc99m-MDP) bone scan was performed, with additional correlative single-photon emission computed tomography (SPECT)/CT imaging of the pelvis and the results were essentially normal. A percutaneous core biopsy of one of the bone lesions in L5 was performed and histology confirmed small cell (neuroendocrine) variant of prostate cancer. Our case illustrates a possible pitfall in molecular imaging of prostate carcinomas, whereby both bone scintigraphy and FCH PET/CT scans showed no definite bone lesions to correlate with marrow signal abnormalities seen on MR imaging. This highlights the need for caution in the diagnostic evaluation of prostate cancers with known small cell variants.
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publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series World Journal of Nuclear Medicine
spelling doaj-art-51dc68ccad6643a7bbce96e2b0d296902025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122012-04-011102757810.4103/1450-1147.103422False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variantAmmad Al-Tamimi0Andrew Tan1Sidney Kwong2Christopher Sam3Angela Chong4Cher Tan5Department of Nuclear Medicine and PET, Singapore General Hospital, SingaporeDepartment of Nuclear Medicine and PET, Singapore General Hospital, SingaporeDepartment of Nuclear Medicine and PET, Singapore General Hospital, SingaporeDepartment of Urology, Singapore General Hospital, SingaporeDepartment of Pathology, Singapore General Hospital, SingaporeDepartment of Diagnostic Radiology, Tan Tock Seng General Hospital, SingaporeWe present a rare variant of prostate carcinoma. The patient is a 45-year-old male with elevated prostate-specific antigen levels at screening. Magnetic resonance imaging revealed hyperenhancing lesions throughout the axial skeleton. The fluorine-18 fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) scan showed no abnormal bone findings. Subsequently, a technetium-99 methydiphosphonate (Tc99m-MDP) bone scan was performed, with additional correlative single-photon emission computed tomography (SPECT)/CT imaging of the pelvis and the results were essentially normal. A percutaneous core biopsy of one of the bone lesions in L5 was performed and histology confirmed small cell (neuroendocrine) variant of prostate cancer. Our case illustrates a possible pitfall in molecular imaging of prostate carcinomas, whereby both bone scintigraphy and FCH PET/CT scans showed no definite bone lesions to correlate with marrow signal abnormalities seen on MR imaging. This highlights the need for caution in the diagnostic evaluation of prostate cancers with known small cell variants.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103422fluorocholinepositron emission tomographyprostate carcinomasmall cell cancer
spellingShingle Ammad Al-Tamimi
Andrew Tan
Sidney Kwong
Christopher Sam
Angela Chong
Cher Tan
False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
World Journal of Nuclear Medicine
fluorocholine
positron emission tomography
prostate carcinoma
small cell cancer
title False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
title_full False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
title_fullStr False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
title_full_unstemmed False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
title_short False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant
title_sort false negative bone scan and choline pet ct study in a case of prostate cancer the pitfall of the small cell prostate carcinoma variant
topic fluorocholine
positron emission tomography
prostate carcinoma
small cell cancer
url http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103422
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