Bone Lipogranuloma Mimicking Metastatic Disease on 18F-FDG PET/CT

Area of Science:

• Oncology
• Nuclear Medicine
• Pathology

Background:

• Primary bone lipogranuloma is an exceptionally rare condition.
• It involves a granulomatous inflammatory response to lipids within bone tissue.
• The condition's rarity and variable presentation can complicate diagnosis.

Observation:

• This report details a case of primary bone lipogranuloma in a breast cancer patient.
• The lesion exhibited significant and intense uptake of 18F-FDG (fluorodeoxyglucose).
• This high metabolic activity on PET/CT was noted.

Findings:

• The intense 18F-FDG uptake in the bone lipogranuloma mimicked metastatic breast cancer.
• This imaging finding posed a diagnostic dilemma, potentially leading to misinterpretation as malignancy.
• Histopathological examination confirmed the diagnosis of lipogranuloma, distinct from metastatic disease.

Implications:

• Awareness of primary bone lipogranuloma is crucial for accurate interpretation of 18F-FDG PET/CT scans.
• This condition highlights the importance of integrating imaging findings with clinical context and, when necessary, biopsy.
• Distinguishing lipogranuloma from metastatic lesions can prevent unnecessary aggressive treatment and improve patient management.