Intense 18 F-FDG Activity of Aneurysmal Bone Cyst

Area of Science:

• Orthopedic Surgery
• Nuclear Medicine
• Radiology

Background:

• Solitary vertebral lesions can present diagnostic challenges.
• 18F-FDG PET/CT is a valuable tool in evaluating bone lesions.
• Aneurysmal bone cysts (ABCs) are benign, expansile bone tumors.

Purpose of the Study:

• To report a case of aneurysmal bone cyst in a young adult with neck pain.
• To highlight the significant 18F-FDG uptake of an ABC on PET/CT.
• To emphasize the importance of considering ABC in the differential diagnosis of FDG-avid vertebral lesions.

Main Methods:

• A 20-year-old male patient presented with neck pain.
• Diagnostic imaging included contrast-enhanced CT and 18F-FDG PET/CT.
• Surgical excision and histopathological examination confirmed the diagnosis.

Main Results:

• CT revealed a heterogeneously enhancing mass in the C5 vertebra posterior elements.
• 18F-FDG PET/CT demonstrated high FDG avidity (SUVmax 7.61) in the solitary lesion.
• Postoperative pathology confirmed the lesion as an aneurysmal bone cyst.

Conclusions:

• Aneurysmal bone cysts can exhibit intense 18F-FDG uptake, mimicking malignant lesions.
• In cases of solitary, FDG-avid vertebral lesions, ABC should be considered in the differential diagnosis.
• This case expands the understanding of ABC imaging characteristics on PET/CT.