Utility of serum tumor markers as an aid in the differential diagnosis of patients with clinical suspicion of cancer and in patients with cancer of unknown primary site.

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Abstract

[Indexed for MEDLINE] 3. BMJ Case Rep. 2019 Apr 23;12(4):e218839. doi: 10.1136/bcr-2016-218839. Comprehensive molecular imaging of malignant transformation of giant cell tumour of bone reveals diverse disease biology. Kairemo K(1), Wang WL(2), Subbiah V(3). Author information: (1)Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. (2)Division of Pathology/Lab Medicine, Department of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. (3)Division of Cancer Medicine, Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Malignant transformation of giant cell tumour of the bone is extremely rare. In addition, bone transformation in giant cell tumour may occur in different phases. With conventional X-rays, CT scans or MRIs, it may be challenging to distinguish among different phases of bone transformation, normal bone, soft tissue disease and bone disease (benign vs malignant lesions) and changes in multiple organs such as lung, liver and lymph nodes unless every lesion is biopsied, which is not practical. Molecular imaging with different isotopes (Tc-99m phosphonate, 2-deoxy-2-(18F)fluoro-d-glucose and sodium fluoride-18) may help to better characterise the disease. We hypothesised that molecular imaging could offer qualitative and quantitative characterisation of all stages of bone formation, destruction, reactivity or neoplasia in a patient with giant cell tumour of the bone, and we present the first case of molecular imaging where bone formation was seen in multiple soft tissues, such as lungs, muscles, lymph nodes and liver. © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ. DOI: 10.1136/bcr-2016-218839 PMCID: PMC6510129