Mimicking Extensive Bone Metastases in FDG PET Scan in An Oral Cancer Patient with Polyostotic Fibrous Dysplasia

Received 6/12/2006; revised 9/13/2006; accepted 9/14/2006. For correspondence or reprints contact: Kun-Ju Lin, M.D., Ph.D., Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, 5 Fu-Shin Street, Kueishan, Taoyuan 333, Taiwan. Tel: (886)3-3281200 ext. 2625, Fax: (886)3-3281200 ext. 2625, E-mail: [email protected] Bone metastases are the second most frequent site of distant metastasis in head and neck cancer. It has been shown that F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is able to identify primary lesion, lymph node involvement, and distant metastasis or other secondary tumor in head and neck cancer patients. Herein, we present a case of head and neck cancer with multiple abnormal FDG accumulation in the skeletal system. The abnormal FDG uptake was considered as polyostotic fibrous dysplasia, instead of multiple bone metastases depicting from a series of previous bone scans, clinical follow up and presentation of morphologic pictures in FDG PET studies. To the best of our knowledge, this is the first case report of the coexistence of polyostotic fibrous dysplasia and head and neck cancer on FDG PET scan.