False Suggestion of Malignant Transformation of Benign Bone Tumor by 18F-FDG PET/CT: A Potential Pitfall

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A 68-year-old man underwent serial 18F-FDG PET/CT scan follow-up for lung cancer. Then 5.5 years after the initial 18F-FDG PET/CT scan, the presumed benign bone tumor in the left clavicle showed markedly increased FDG uptake during follow-up; in contrast, the 99mTc-MDP bone scan paradoxically exhibited no apparent interval change since last bone scan 5.5 years earlier. He underwent a CT-guided biopsy, and the pathological diagnosis was benign fibrous histiocytoma. The result was consistent with the lack of progression in 99mTc-MDP bone scan, whereas the 18F-FDG PET/CT scan gave a false-positive impression of malignant transformation.

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