Akademik Veri Yönetim Sistemi
Annual Congress of the European Association of Nuclear Medicine (EANM'24), Hamburg, Almanya, 19 - 23 Ekim 2024, cilt.51, ss.864-865
Aim/Introduction: Hemangiomas are benign tumors that develop from the proliferation of normal or abnormal vascular structures. While these lesions grow slowly and remain asymptomatic, they can lead to symptoms or complications depending on their location and their efects on surrounding structures. When other modalities fail to provide a diagnosis, Tc99m labeled erythrocyte scintigraphy is a reliable imaging tool for the diferential diagnosis. In this case presentation, we aimed to contribute to the literature by highlighting the role of Tc-99m labeled erythrocyte scintigraphy in the diagnosis of a mediastinal hemangioma mimicking low FDG-avid malignancy on FDG PET/ CT. Materials and Methods: A 43-year-old female patient was referred to the surgical clinic after the detection of a malignant nodule in the right lobe of the thyroid gland. Contrast-enhanced CT images revealed an incidentally detected heterogeneous contrast-enhancing mass lesion with microcalcifcations, extending to the left supraglottic region and surrounding the vascular structures and the esophagus down to the infracarinal level in the mediastinum. Further evaluation for malignancy investigation with FDG PET/CT revealed mild heterogeneous FDG uptake in the described mass lesion, equivalent to the mediastinal blood pool. Considering the fndings, diferential diagnosis included both low FDG-avid malignancies and hemangiomas, given the contrast uptake identifed on preoperative CT and the equivalence of FDG uptake with the mediastinal blood pool. Due to the risk of bleeding, histopathological confrmation could not be obtained from the mediastinal mass. Therefore, Tc-99m labeled erythrocyte scintigraphy was planned for diagnostic purposes. Results: In the Tc-99m labeled erythrocyte scintigraphy, increased uptake of labeled erythrocytes was observed, and the described lesion was evaluated in favor of mediastinal cavernous hemangioma. Conclusion: Mediastinal cavernous hemangioma is a rare, benign tumor originating from vascular endothelial cells. Imaging characteristics manifest as oval-shaped masses with welldefned borders. However, invasion of adjacent organs may lead to their classifcation as malignant lesions. Morphological fndings from CT and MRI may not always defnitively rule out malignancy. Tc-99m labeled erythrocyte scintigraphy is a reliable imaging tool for the diferential diagnosis. Cases of mediastinal cavernous hemangioma evaluated with Tc-99m labeled erythrocyte scintigraphy are limited in the literature, and thus, this case constitutes an important example in this context.