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Syphilitic bone destruction on FDG PET/CT.

Xinlu Wang¹, Jilin Yin, Xiaodong Chen

¹Department of Nuclear Medicine, Guangzhou General Hospital of Guangzhou Military Area Command, Guangzhou, Guangdong, People's Republic of China. 71lu@163.com

Clinical Nuclear Medicine

|June 4, 2011

Summary

A PET/CT scan revealed widespread bone lesions in a 35-year-old man. These lesions, initially suspected as cancer metastases, were ultimately diagnosed as syphilis infection.

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Area of Science:

Nuclear Medicine
Radiology
Infectious Disease

Background:

Positron Emission Tomography/Computed Tomography (PET/CT) is crucial for cancer staging.
Osseous metastases often present as areas of increased fluorodeoxyglucose (FDG) uptake on PET scans.

Observation:

A 35-year-old male presented with suspected metastatic bone disease.
PET/CT imaging showed multiple hypermetabolic lesions in the extremities, correlating with bone destruction on CT.
No primary tumor was identified to explain the metastatic findings.

Findings:

The extensive bone lesions and hypermetabolism on PET/CT were definitively diagnosed as syphilis.
This case highlights a rare presentation of tertiary syphilis mimicking osseous metastases.

Implications:

Clinicians should consider syphilis in the differential diagnosis of unexplained osseous lesions, especially when malignancy is not evident.
PET/CT findings in syphilis can mimic metastatic disease, necessitating careful correlation with clinical and serological data.
This underscores the importance of a broad differential diagnosis in interpreting imaging findings.