PMC6243364_01
99mTc-methylene diphosphonate whole-body bone scan showing intense uptake in several right facial bones, including the frontal, zygomatic and nasal bones, maxilla and mandible. There was also intense uptake involving the right ribcage. Whole-body planar anterior and posterior images and single-photon emission CT coronal images of the thorax are shown.
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There was also intense uptake involving the right ribcage (Figure 1).
18F-fludeoxyglucose positron emission tomography/CT maximum intensity projection images showing intense heterogeneous 18F-fludeoxyglucose uptake in the bones of the right face and right hemithorax.
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Maximum intensity projection images showed intense heterogeneous 18F-FDG uptake in the bones of the right face and right hemithorax (Figure 2).
The 18F-fludeoxyglucose uptake in the facial bones was variable, with maximum standardized uptake value ranging from 2.1 to a maximum of 5.4 in the right maxillary bone. The right hemithorax lesions appeared to arise from the right eighth and ninth ribs, with involvement of the T7 vertebra, which was collapsed. The maximum standardized uptake value in the right hemithorax lesions ranged from 4.0 to 7.5.
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T7 vertebra, which was collapsed. The SUVmax in the right hemithorax lesions ranged from 4.0 to 7.5 (Figure 3).
A CT scan performed 8 years later showed stability of the benign fibrous dysplasia lesions in the skull and thorax.
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SUVmax values raised concern of malignant transformation (or sarcomatous degeneration), and follow-up with a CT scan was recommended. Subsequent 8 years of follow-up with CT scans (Figure 4) did not reveal the development of any aggressive bone lesions, and the patient remains clinically stable with no evidence of malignant transformation.