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We report a case of a 69-year-old woman with primary hyperoxaluria type I, who developed a severe hypercalcemia despite controlled secondary hyperparathyroidism. Bone scintigraphy showed diffuse increased uptake in axial and peripheral skeleton. F-FDG PET/CT showed countless striking hypermetabolic foci, interesting 2 types of lesions (joint calcifications and periosteal resorptions). Bone biopsy demonstrated inflammatory changes around many calcium oxalate crystals; hypercalcemia was then related to oxalate osteopathy. Immunotherapy with denosumab was thus initiated. Eighteen months later, a second PET/CT showed decreased F-FDG uptake, reflecting treatment efficacy on inflammatory reaction secondary to calcium oxalosis skeletal deposits.

We present the case of a 40-year-old man consulting for uncontrollable episodes of laughing related to emotional lability and not systematically linked to feelings of happiness. Seven months earlier he had presented a pontine ischemic stroke related to an occlusion of the basilar and left vertebral arteries. No epileptic activity or new MRI brain lesions were found. Brain perfusion SPECT performed showed marked hypoperfusion in the right frontal inferior and temporoinsular regions, suggesting a diaschisis phenomenon caused by pontine lesions and highlighted laughing regulation pathways. The patient was successfully treated with a serotonergic reuptake inhibitor, fluoxetine.

We report the case of a 73-year-old woman presenting sudden blindness caused by bilateral simultaneous central retinal artery occlusion revealed by ophthalmoscopy. Temporal artery biopsy confirmed the giant cell arteritis. The patient was treated with a systemic steroid without visual recovery. FDG PET/CT was performed 6 months later in the context of persistent inflammatory syndrome. This case shows the close relationship between functional activity and glucose energy metabolism. We observed both bilateral occipital hypometabolism corresponding to loss of functional activity and bilateral temporal (auditory areas) and orbitofrontal hypermetabolism related to compensatory neuronal plasticity.

Because of its high diagnostic sensitivity in detection of unknown primary tumors, F-18 FDG PET/CT was used in the exploration of a 51-year-old woman presenting with multiple lymphadenopathy of the hepatic hilum and several hepatic and splenic hypodensities on radiologic examinations for which malignancy was suspected. Despite the morphofunctional malignant appearance, both histologic examination and PCR analysis revealed Bartonella henselae infection. Moreover, repeat F-18 FDG PET showed disease regression during focused antibiotic therapy.

Proliferating trichilemmal cyst is considered as a rare tumor that originates in the outer root sheath of hair follicle. Metastatic potential has not been yet fully established. Moreover, histological analysis does not allow precise malignancy prediction. Proliferating trichilemmal cyst glucose metabolism behavior was never previously described. Herein, we report the case of a 62-year-old patient with a left shoulder proliferating trichilemmal cyst showing an intense uptake of ¹⁸F-FDG on PET/CT examination. ¹⁸F-FDG PET/CT could be proposed to optimize diagnostic strategy of patients with proliferating trichilemmal cysts.

Diffuse, increased gastric wall F-18 FDG uptake is widely observed during PET/CT examinations, frequently unrelated to malignant findings, but simply caused by inflammatory disease, physiological emptying, or visceral thickening. Hence, elevated F-18 FDG gastric uptake can lead to equivocal misinterpretation, especially in patients with known gastric malignant disease, at posttherapy reevaluation. Gastric wall contraction can increase F-18 FDG uptake, especially for a remnant stomach, increasing the percentage of false-positive results with a direct impact on therapeutic management. One field PET/CT acquisition centered on the hypochondrial regions a few minutes after water ingestion should be performed routinely if standard images are doubtful (increased tracer uptake and visceral thickening) to differentiate benign from malignant uptake.

In-111 DTPA-D-Phe1-octreotide (In-111 pentetreotide) is a widely used radiotracer for somatostatin receptor (SSTR) in- vestigations in neuroendocrine (NE) pathology. Cellular SSTR den- sity is directly related to the degree of NE cellular differentiation. Poorly differentiated cell lines show a surface reduction of SSTRs, which may lead to misinterpreting the In-111 pentetreotide scintig- raphy results as negative. A case of anorectal small-cell undifferen- tiated neuroendocrine carcinoma is reported. This pathologic finding is rare, highly aggressive, and associated with a dramatic prognosis. The patient was investigated with In-111 pentetreotide SPECT and low-dose computed tomography (CT) for anatomic reference. De- spite its low degree of differentiation, the tumor showed high tracer uptake characterized by a positive incremental trend as shown by comparison of the 4-hour and 24-hour SPECT images, suggesting specific receptorial binding of In-111 pentetreotide.

Prognosis of patients with Bartholin’s gland carcinoma(BGC) is strictly related to the nodal stage at diagnosis. Thus, it iscrucial to perform reliable staging for optimal treatment planning. Inspite of wide clinical utilization of F-18 FDG PET in oncologicalroutine, its role in vulvar malignancies is not completely defined. Tokeep organs and preserve anal and ureteral function, a patient withadvanced undifferentiated BGC (FIGO IV-A) received 50 Gy to thewhole pelvis, whole vagina and bilateral inguinal lymph nodes withconcomitant chemotherapy, followed by interstitial brachytherapy.F-18 FDG PET-CT was performed at staging and after treatmentcompletion. Complete regression of the initial metabolic abnormal-ities was shown on posttreatment images, confirming the efficacy ofthe adopted conservative approach. F-18 FDG PET-CT imagingcould have a role in staging and assessing treatment efficacy inaggressive BGC. Key Words: Bartholin’s gland carcinoma, undifferentiatedcarcinoma, F-18 FDG PET, chemoradiation, brachytherapy(