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Patological fracture of humerus in osteosarcoma - a case report

Publication at Central Library of Charles University |
2019

Abstract

Aim: To present a case report confirming the importance of bone scintigraphy for staging of malignancy. Case report: 29-y-old woman was reffered to our department for a bone scan because of pathological fracture of the left humerus.

The previous MR imaging revealed a pathological infiltration of bone marrow suspected to be hematological malignancy or fibrotic dysplazia. The bone marrow biopsy was planned.

Bone scintigraphy was performed before to detect the metastases. The 3-phase bone scintigraphy with 99mTc -HDP was provided.

On the both second and third phases, the diffuse high accumulation of HDP was detected in the left humerus. High accumulation of HDP was detected in the left humerus on the wholebody scan without other pathological foci.

The SPECT/LDCT of the chest showed diffuse accumulation in the head and in the diaphysis of the left humerus without other foci, therefore, the planned bone marrow biopsy was cancelled. Open biopsy of the humerus was provided instead.

The histological investigation showed chondroblastical osteosarcoma. Conclusion: The bone scintigraphy changed the diagnostic plan.

The patient was saved of functionless bone marrow biopsy.