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Interesting images
18F FDG PET/CT imaging of trichoblastoma of the knee
PET/TC con 18F-FDG en paciente con Tricoblastoma de rodilla
Ba D. Nguyena,
Corresponding author
Nguyen.ba@mayo.edu

Corresponding author.
, David J. DiCaudob
a Department of Radiology, Nuclear Medicine Division, Mayo Clinic Arizona, Scottsdale, AZ, USA
b Department of Dermatology, Mayo Clinic Arizona, Scottsdale, AZ, USA
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 62-year old man had an established diagnosis of POEMS syndrome with peripheral polyneuropathy&#44; hepatosplenomegaly&#44; diabetes&#44; monoclonal gammopathy treated with autologous stem cell transplant&#44; and scleroderma&#46; The patient has been monitored with stability by cross-sectional imaging for 6 years until the onset of a progressively enlarging non-tender nodular lesion of the left knee&#46; A wholebody <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT was performed in search of any potential osseous&#47;soft tissue plasmacytoma or other new malignant lesion&#46; PET&#47;CT detected a tracer-avid focus of the left knee &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; row A &#38; B&#41;&#46; MR imaging showed a well-defined multiseptated lesion&#44; in the subcutaneous fat&#44; anterior and lateral to the patellar tendon measuring 0&#46;9<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>2&#46;1<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#46;8<span class="elsevierStyleHsp" style=""></span>cm with increased signal on fluid sensitive sequences&#44; higher signal to muscles on T1 images and absent contrast enhancement &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; row C&#41;&#46; Ultrasound depicted a hypoechoic lesion with no internal vascularity&#46; Surgery and pathology showed a tumor with basaloid islands and peripheral palisading within a fibrous to fibromucinous stroma&#46; The immunostaining results&#44; ruling out basal cell carcinoma&#44; were compatible with trichoblastoma &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cutaneous manifestations of POEMS syndrome are&#44; in the decreasing order of frequency&#44; hyperpigmentation&#44; hemangioma&#44; hypertrichosis&#44; acrocyanosis&#44; white nails&#44; sclerodermoid changes&#44; Raynaud phenomenon and erythema&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Trichoblastoma&#44; an incidental occurrence in this presented case of POEMS syndrome&#44; is a benign slow-growing cutaneous tumor which may occur at any site with hair follicles predominantly at the head and neck&#46; Usually appearing as a solitary non-ulcerated flesh-colored small skin nodule&#44; it is frequently evaluated by dermatologists and rarely documented on anatomic and functional imaging&#46; A few cases have been radiographically demonstrated incidentally in the breast or upper extremity secondary to an exceptionally large size&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2&#8211;4</span></a> Trichoblastoma may simulate a rare malignant skin lesion due to <span class="elsevierStyleSup">18</span>F-FDG uptake in the context of a progressively enlarging nodular tumor in a patient with POEMS syndrome&#46; With the histologic feature overlap with basal cell carcinoma&#44; the diagnosis of trichoblastoma should be established by a complete surgical resection allowing a comprehensive immunostaining assessment&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In summary&#44; the authors present a tracer-avid trichoblastoma&#44; which was suspicious for malignancy on <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT imaging&#46; Histologic immunostaining is necessary for the identification of this benign cutaneous neoplasm&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
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ISSN: 22538089
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos