Indian Journal of Nuclear Medicine
Home | About IJNM | Search | Current Issue | Past Issues | Instructions | Ahead of Print | Online submissionLogin 
Indian Journal of Nuclear Medicine
  Editorial Board | Subscribe | Advertise | Contact
Users Online: 593 Print this page  Email this page Small font size Default font size Increase font size


 
 Table of Contents     
LETTER TO EDITOR
Year : 2012  |  Volume : 27  |  Issue : 1  |  Page : 64-65  

Synovial sarcoma with isolated bone metastases, demonstrated by 99m Tc-MDP bone scintigraphy and 18 F-FDG PET/CT


Department of Nuclear Medicine and PET, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication15-Mar-2013

Correspondence Address:
Bhagwant Rai Mittal
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.108896

Rights and Permissions

How to cite this article:
Senthil R, Kashyap R, Bhattacharya A, Mittal BR. Synovial sarcoma with isolated bone metastases, demonstrated by 99m Tc-MDP bone scintigraphy and 18 F-FDG PET/CT. Indian J Nucl Med 2012;27:64-5

How to cite this URL:
Senthil R, Kashyap R, Bhattacharya A, Mittal BR. Synovial sarcoma with isolated bone metastases, demonstrated by 99m Tc-MDP bone scintigraphy and 18 F-FDG PET/CT. Indian J Nucl Med [serial online] 2012 [cited 2022 Jan 22];27:64-5. Available from: https://www.ijnm.in/text.asp?2012/27/1/64/108896

Sir,

We describe a 25-year-old female patient, a known case of synovial sarcoma of lower end of left femur, who had undergone above knee amputation 5 years ago presented with low backache of 1-month duration. She was subjected to 99m Tc -MDP bone scintigraphy to look for bone metastases. Whole-body bone scan in anterior projection [Figure 1]a and spot images in posterior view [Figure 1]b-e showed increased tracer uptake in multiple thoraco-lumbar vertebrae, right pubic bone, and right femoral head suggestive of widespread skeletal metastases. 18 F-FDG PET/CT showed intense FDG uptake in the lytic lesions in multiple vertebrae, bilateral ribs, pelvis, and femora with soft tissue components along the pubic bones [Figure 2]a-d. CT scan showed multiple lytic lesions in the lower thoracic and lumbar vertebrae, right pubic bone, and right femoral head, consistent with metastases. However no FDG uptake or any nodules was seen in the lung parenchyma on either side [Figure 2]e.
Figure 1:99mTc-MDP bone scintigraphy whole body in anterior projection (a) and spot images in posterior view (b-e), showing increased tracer uptake in multiple thoraco-lumbar vertebrae, right pubic bone, and right femoral head suggestive of widespread skeletal metastases

Click here to view
Figure 2: 18F-FDG PET/CT showing intense FDG uptake in the lytic lesions in multiple vertebrae, bilateral ribs, pelvis, and femora with soft tissue components along the pubic bones (a-d). No FDG uptake or any nodules is seen in the lung parenchyma on either side (e)

Click here to view


Synovial sarcoma is the fourth most common type of soft-tissue sarcoma, accounting for 2.5-10.5% of all primary soft-tissue malignancies worldwide. [1],[2],[3],[4],[5] Metastatic disease occurs approximately in 50% of patients. [6] The most frequent metastatic site is the lung, affected in almost 94% of cases, followed by lymph nodes (4-18%). Even though bone metastases occur in 8-11% of patients, most of these patients also have lung metastases. [7],[8],[9] Isolated bone metastasis in the absence of lung involvement in synovial sarcoma is rare. Bone scintigraphy is a useful modality in the assessment of bone metastases in patients with synovial sarcoma. 18 F-FDG PET/CT may be recommended as one stop shop investigation in the evaluation of these patients to detect bony as well as other organ involvement.



 
   References Top

1.Hare HF, Cerny MJ Jr. Soft tissue sarcoma: A review of 200 cases. Cancer 1963;16:1332-7.  Back to cited text no. 1
[PUBMED]    
2.Cadman NL, Soule EH, Kelly PJ. Synovial sarcoma: An analysis of 34 tumors. Cancer 1965;18:613-27.  Back to cited text no. 2
[PUBMED]    
3.Thompson DE, Frost HM, Hendrick JW, Horn RC Jr. Soft tissue sarcomas involving the extremities and the limb girdles: A review. South Med J 1971;64:33-44.  Back to cited text no. 3
[PUBMED]    
4.Tsujimoto M, Aozasa K, Ueda T, Sakurai M, Ishiguro S, Kurata A, et al. Soft tissue sarcomas in Osaka, Japan (1962-1985): Review of 290 cases. Jpn J Clin Oncol 1988;18:231-4.  Back to cited text no. 4
[PUBMED]    
5.Gustafson P. Soft tissue sarcoma: Epidemiology and prognosis in 508 patients. Acta Orthop Scand Suppl 1994;259:1-31.  Back to cited text no. 5
[PUBMED]    
6.Trassard M, Le Doussal V, Hacène K, Terrier P, Ranchère D, Guillou L, et al. Prognostic factors in localized primary synovial sarcoma: A multicenter study of 128 adult patients. J Clin Oncol 2001;19:525-34.  Back to cited text no. 6
    
7.Spurrell EL, Fisher C, Thomas JM, Judson IR. Prognostic factors in advanced synovial sarcoma: An analysis of 104 patients treated at the Royal Marsden Hospital. Ann Oncol 2005;16:437-44.  Back to cited text no. 7
[PUBMED]    
8.Paulino AC. Synovial sarcoma prognostic factors and patterns of failure. Am J Clin Oncol 2004;27:122-7.  Back to cited text no. 8
[PUBMED]    
9.Ryan JR, Baker LH, Benjamin RS. The natural history of metastatic synovial sarcoma: Experience of the Southwest Oncology group. Clin Orthop Relat Res 1982;164:257-60.  Back to cited text no. 9
[PUBMED]    


    Figures

  [Figure 1], [Figure 2]


This article has been cited by
1 Low grade sinonasal sarcoma with neural and myogenic features - diagnostic challenge and pathogenic insight
Kathleen A. Powers,Lucy M. Han,Alexander G. Chiu,F. Zahra Aly
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2014;
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed1128    
    Printed41    
    Emailed0    
    PDF Downloaded99    
    Comments [Add]    
    Cited by others 1    

Recommend this journal