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The role of 18F-FDG PET/CT for diagnosis of Paget’s disease of bone with cranial and spinal compromise: Case report and literature review
El rol de la 18F-FDG PET/TC para el diagnóstico de la enfermedad ósea de Paget con compromiso craneal y espinal: reporte de caso y revisión de la literatura
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Andrés David Ramírez-Sanabriaa, María Alejandra Valeroa,b, Rubén D. Mantilla-Hernándezc, Edgar Gerardo Ordóñez-Rubianod,
Corresponding author
egordonez@fucsalud.edu.co

Corresponding author.
a Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
b Service of Family Medicine, Faculty of Health Sciences, Pontificia Universidad Javeriana, Cali, Colombia
c Department of Rheumatology, Centro de Estudios de Enfermedades Autoinmunes (CREA), Bogotá, Colombia
d Neurosurgery Service, Hospital de San José, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
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Received 28 February 2021. Accepted 12 May 2021
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Table 1. Histopathological studies.
Table 2. Biochemical tests.
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Abstract

Paget's disease of bone (PDB) is a benign disorder characterized by focal areas of bone turnover. So far, only 17 cases have been described in Colombia. We present the case of a 68-year-old male who presented with otorrhea and deafness. The skull x-rays and computerized tomography findings were suggestive of malignancy. Consequently, an 18F-FDG PET/CT was performed and showed intense uptake in the skull and lumbar spine. The workup showed elevated alkaline phosphatase levels consistent with PDB and the biopsy ruled out other differential diagnoses. The patient received alendronate with symptomatic improvement and decreased alkaline phosphatase levels.

Keywords:
Paget's disease of bone
Osteitis deformans
Otorrhagia
18F-FDG PET/CT
Colombia
Resumen

La enfermedad ósea de Paget (EOP) es un trastorno benigno, caracterizado por áreas focales de recambio óseo. Hasta el momento solo se han descrito 17 casos en Colombia. Se presenta el caso de un paciente masculino de 68 años que consultó por otorrea e hipoacusia. Los hallazgos en la radiografía y la tomografía computarizada fueron sugestivos de malignidad craneana, se realizó una 18F-FDG PET/CT que mostró hipercaptación en el cráneo y en la columna lumbar. Se encontraron niveles altos de fosfatasa alcalina consistente con EOP. La biopsia descartó otros diagnósticos diferenciales. El paciente recibió alendronato y experimentó una mejoría sintomática y disminución de la fosfatasa alcalina.

Palabras clave:
Enfermedad ósea de Paget
Osteítis deformante
Otorragia
18F-FDG PET/CT
Colombia

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