Osteomyelitis Post Nerve Blockage as the Implication of Bone Scan in a Patient With Pancreatic Neuroendocrine Tumor: A Case Report
Abstract
A 41-year-old female with retractable epigastric pain due to an invasive neuroendocrine tumor of the pancreas was treated with blockage and radiofrequency ablation of the celiac and splanchnic plexuses. Then, the patient developed back pain, and a bone scan revealed abnormal uptake in the lower thoracic vertebrae despite a normal CT scan. The findings were interpreted as a local invasion of the tumor or iatrogenic post-manipulation inflammation or infection. MRI data presented the destruction of the thoracic 11th and 12th vertebrae, and pathology examination of the open biopsy sample favored inflammatory changes.
[1] Pneumaticos SG, Savidou C, Korres DS, Chatziioannou SN. Pancre- atic cancer’s initial presentation: Back pain due to osteoblastic bone metastasis. European Journal of Cancer Care. 2010; 19(1):137-40. [DOI:10.1111/j.1365-2354.2007.00920.x] [PMID]
[2] Filippiadis DK, Tutton S, Kelekis A. Percutaneous bone lesion ab- lation. La Radiologia Medica. 2014; 119(7):462-9. [DOI:10.1007/ s11547-014-0418-8] [PMID]
[3] Bombardieri E, Setti L, Kirienko M, Antunovic L, Guglielmo P, Ciocia G. Which metabolic imaging, besides bone scan with 99mTc-phos- phonates, for detecting and evaluating bone metastases in prostatic cancer patients? An open discussion. The Quarterly Journal of Nu- clear Medicine and Molecular Imaging. 2015; 59(4):381-99. [PMID]
[4] Iagaru A, Mittra E, Dick DW, Gambhir SS. Prospective evaluation of (99m)Tc MDP scintigraphy, (18)F NaF PET/CT, and (18)F FDG PET/CT for detection of skeletal metastases. Molecular Imaging and Biol- ogy. 2012; 14(2):252-9. [DOI:10.1007/s11307-011-0486-2] [PMID]
[5] Palmedo H, Marx C, Ebert A, Kreft B, Ko Y, Türler A, et al. Whole- body SPECT/CT for bone scintigraphy: Diagnostic value and effect on patient management in oncological patients. European Journal of Nuclear Medicine and Molecular Imaging. 2014; 41(1):59-67. [DOI:10.1007/s00259-013-2532-6] [PMID]
[6] Jung JH, Won HJ, Shin YM, Kim PN. Safety and efficacy of radiofre- quency ablation for hepatic metastases from gastrointestinal stro- mal tumor. Journal of Vascular and Interventional Radiology. 2015; 26(12):1797-802. [DOI:10.1016/j.jvir.2015.09.002]
[7] Masciocchi C, Zugaro L, Arrigoni F, Gravina GL, Mariani S, La Marra A,et al.Radiofrequency ablation versus magnetic resonance guided focused ultrasound surgery for minimally invasive treatment of oste- oid osteoma: A propensity score matching study. European Radiolo- gy. 2016; 26(8):2472-81. [DOI:10.1007/s00330-015-4111-7] [PMID][8] Song TJ, Seo DW, Lakhtakia S, Reddy N, Oh DW, Park DH, et al. Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. Gastrointestinal Endoscopy. 2016; 83(2):440-3. [DOI:10.1016/j.gie.2015.08.048] [PMID]
[9] Guibal A, Bertin C, Egels S, Savier E, Grenier PA, Lucidarme O. Contrast-enhanced ultrasound (CEUS) follow-up after radiofre- quency ablation or cryoablation of focal liver lesions: Treated-area patterns and their changes over time. European Radiology. 2013; 23(5):1392-400. [DOI:10.1007/s00330-012-2702-0] [PMID]
[10] Wood MA, Fuller IA. Acute and chronic electrophysiologic changes surrounding radiofrequency lesions. Journal of Cardiovas- cular Electrophysiology. 2002; 13(1):56-61. [DOI:10.1046/j.1540- 8167.2002.00056.x] [PMID]
[11] Girelli R, Frigerio I, Salvia R, Barbi E, Tinazzi Martini P, Bassi C. Fea- sibility and safety of radiofrequency ablation for locally advanced pancreatic cancer. The British Journal of Surgery. 2010; 97(2):220-5. [DOI:10.1002/bjs.6800] [PMID]
[12] Koizumi M, Wagatsuma K, Miyaji N, Murata T, Miwa K, Takiguchi T, et al. Evaluation of a computer-assisted diagnosis system, BONE- NAVI version 2, for bone scintigraphy in cancer patients in a routine clinical setting. Annals of Nuclear Medicine. 2015; 29(2):138-48. [DOI:10.1007/s12149-014-0921-y] [PMID]
[2] Filippiadis DK, Tutton S, Kelekis A. Percutaneous bone lesion ab- lation. La Radiologia Medica. 2014; 119(7):462-9. [DOI:10.1007/ s11547-014-0418-8] [PMID]
[3] Bombardieri E, Setti L, Kirienko M, Antunovic L, Guglielmo P, Ciocia G. Which metabolic imaging, besides bone scan with 99mTc-phos- phonates, for detecting and evaluating bone metastases in prostatic cancer patients? An open discussion. The Quarterly Journal of Nu- clear Medicine and Molecular Imaging. 2015; 59(4):381-99. [PMID]
[4] Iagaru A, Mittra E, Dick DW, Gambhir SS. Prospective evaluation of (99m)Tc MDP scintigraphy, (18)F NaF PET/CT, and (18)F FDG PET/CT for detection of skeletal metastases. Molecular Imaging and Biol- ogy. 2012; 14(2):252-9. [DOI:10.1007/s11307-011-0486-2] [PMID]
[5] Palmedo H, Marx C, Ebert A, Kreft B, Ko Y, Türler A, et al. Whole- body SPECT/CT for bone scintigraphy: Diagnostic value and effect on patient management in oncological patients. European Journal of Nuclear Medicine and Molecular Imaging. 2014; 41(1):59-67. [DOI:10.1007/s00259-013-2532-6] [PMID]
[6] Jung JH, Won HJ, Shin YM, Kim PN. Safety and efficacy of radiofre- quency ablation for hepatic metastases from gastrointestinal stro- mal tumor. Journal of Vascular and Interventional Radiology. 2015; 26(12):1797-802. [DOI:10.1016/j.jvir.2015.09.002]
[7] Masciocchi C, Zugaro L, Arrigoni F, Gravina GL, Mariani S, La Marra A,et al.Radiofrequency ablation versus magnetic resonance guided focused ultrasound surgery for minimally invasive treatment of oste- oid osteoma: A propensity score matching study. European Radiolo- gy. 2016; 26(8):2472-81. [DOI:10.1007/s00330-015-4111-7] [PMID][8] Song TJ, Seo DW, Lakhtakia S, Reddy N, Oh DW, Park DH, et al. Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. Gastrointestinal Endoscopy. 2016; 83(2):440-3. [DOI:10.1016/j.gie.2015.08.048] [PMID]
[9] Guibal A, Bertin C, Egels S, Savier E, Grenier PA, Lucidarme O. Contrast-enhanced ultrasound (CEUS) follow-up after radiofre- quency ablation or cryoablation of focal liver lesions: Treated-area patterns and their changes over time. European Radiology. 2013; 23(5):1392-400. [DOI:10.1007/s00330-012-2702-0] [PMID]
[10] Wood MA, Fuller IA. Acute and chronic electrophysiologic changes surrounding radiofrequency lesions. Journal of Cardiovas- cular Electrophysiology. 2002; 13(1):56-61. [DOI:10.1046/j.1540- 8167.2002.00056.x] [PMID]
[11] Girelli R, Frigerio I, Salvia R, Barbi E, Tinazzi Martini P, Bassi C. Fea- sibility and safety of radiofrequency ablation for locally advanced pancreatic cancer. The British Journal of Surgery. 2010; 97(2):220-5. [DOI:10.1002/bjs.6800] [PMID]
[12] Koizumi M, Wagatsuma K, Miyaji N, Murata T, Miwa K, Takiguchi T, et al. Evaluation of a computer-assisted diagnosis system, BONE- NAVI version 2, for bone scintigraphy in cancer patients in a routine clinical setting. Annals of Nuclear Medicine. 2015; 29(2):138-48. [DOI:10.1007/s12149-014-0921-y] [PMID]
| Files | ||
| Issue | Vol 6 No 5 (2021): September-October | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v6i5.8376 | |
| Keywords | ||
| Technetium Tc 99m medronate Radiofrequency ablation Neuroendocrine tumors Osteomyelitis | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Farzanehfar S, Mirzabeigi A, Ghalandari N, Abbasi M. Osteomyelitis Post Nerve Blockage as the Implication of Bone Scan in a Patient With Pancreatic Neuroendocrine Tumor: A Case Report. CRCP. 2022;6(5):185-188.
