Coexistence of Paget disease and lung cancer - importance of patient management
Authors: Nevena Manevska, Anamarija Jankulovska, Dusica Todorova Stefanovski, Tanja Makazlieva, Sinisa Stojanoski
Background: The coexistence of metabolic bone disease, such as Paget disease (PD) and malignant tumor is frequently described in patients with breast, prostate, lung, lymphoproliferative, colorectal, and renal neoplasms. Indeed, when evaluating cancer patients, there may be diagnostic dilemma of interpreting some changes in bone involvement, whether they are malignant or metabolic changes, since some radiological features of metabolic bone disease can mimic those of bone metastases. Case Presentation: We report a case of 55-year-old male patient, with diagnosed lung adenocarcinoma, referred to the Nuclear Medicine Department for a bone scintigraphy (BS), for evaluation of presented bone metastasis. The Single photon emission computed tomography (SPECT)/computer tomography (CT) scan revealed intensive metabolic accumulation of the radiotracer in cervical vertebra C7, and thoracic vertebra Th1, Th6, Th11, Th12, as well as lumbar vertebra L4, L5, left sacroiliac joint, both iliac and pubic bones and left proximal femur. The FDG PET/CT showed diffuse, but mildly increased uptake in Тh6, Тh11, L4, L5 and pelvic bones (SUV max = 3.3). The CT revealed destruction of Th11 body with compression fracture. Diagnosis of PD was made based on the findings of BS and PET/CT and further confirmed on bone biopsy and the patient was started with bisphosphonate therapy. Conclusion: BS and SPECT/CT are of great importance in accurate detection of incidental PD in patients with lung cancer.
Keywords: Bone scan, SPECT/CT, bone metastasis, Paget disease, lung cancer, case report
Authors
Nevena Manevska
Medical Faculty, Institute of Pathophysiology and Nuclear medicine, Acad. Isak S. Tadzer, University of Ss. Cyril and Methodius, Skopje, Macedonia
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Anamarija Jankulovska
Medical Faculty, Institute of Pathophysiology and Nuclear medicine, Acad. Isak S. Tadzer, University of Ss. Cyril and Methodius, Skopje, Macedonia
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Tanja Makazlieva
Medical Faculty, Institute of Pathophysiology and Nuclear medicine, Acad. Isak S. Tadzer, University of Ss. Cyril and Methodius, Skopje, Macedonia
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Correspondence to:
Nevena Manevska, Medical Faculty, Institute of Pathophysiology and Nuclear medicine, Acad Isak S Tadzer, University of Ss Cyril and Methodius, Skopje, Macedonia dr.nmanevska@gmail.com
Publication history:
Received 23 Oct 2021
Revised 28 Nov 2021
Accepted 18 Dec 2021
Published online 29 Jan 2022
Published in print 13 Feb 2022
Manevska N, Jankulovska A, Stefanovski DT, Makazlieva T, Stojanoski S. Coexistence of Paget disease and lung cancer - importance of patient management. EJMCR. 2022; 6(1): 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska N, Jankulovska A, Stefanovski DT, Makazlieva T, Stojanoski S. Coexistence of Paget disease and lung cancer - importance of patient management. https://www.ejmcr.com/?mno=135177 [Access: May 01, 2024]. doi:
10.24911/ejmcr/173-1634979125
Manevska N, Jankulovska A, Stefanovski DT, Makazlieva T, Stojanoski S. Coexistence of Paget disease and lung cancer - importance of patient management. EJMCR. 2022; 6(1): 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska N, Jankulovska A, Stefanovski DT, Makazlieva T, Stojanoski S. Coexistence of Paget disease and lung cancer - importance of patient management. EJMCR. (2022), [cited May 01, 2024]; 6(1): 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska, N., Jankulovska, . A., Stefanovski, . D. T., Makazlieva, . T. & Stojanoski, . S. (2022) Coexistence of Paget disease and lung cancer - importance of patient management. EJMCR, 6 (1), 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska, Nevena, Anamarija Jankulovska, Dusica Todorova Stefanovski, Tanja Makazlieva, and Sinisa Stojanoski. 2022. Coexistence of Paget disease and lung cancer - importance of patient management. European Journal of Medical Case Reports, 6 (1), 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska, Nevena, Anamarija Jankulovska, Dusica Todorova Stefanovski, Tanja Makazlieva, and Sinisa Stojanoski. "Coexistence of Paget disease and lung cancer - importance of patient management." European Journal of Medical Case Reports 6 (2022), 21-26. doi:
10.24911/ejmcr/173-1634979125
Manevska, Nevena, Anamarija Jankulovska, Dusica Todorova Stefanovski, Tanja Makazlieva, and Sinisa Stojanoski. "Coexistence of Paget disease and lung cancer - importance of patient management." European Journal of Medical Case Reports 6.1 (2022), 21-26. Print. doi:
10.24911/ejmcr/173-1634979125
Manevska, N., Jankulovska, . A., Stefanovski, . D. T., Makazlieva, . T. & Stojanoski, . S. (2022) Coexistence of Paget disease and lung cancer - importance of patient management. European Journal of Medical Case Reports, 6 (1), 21-26. doi:
10.24911/ejmcr/173-1634979125