Large renal carbuncle mimicking intra-abdominal neoplasm on Ga-67 scintigraphy: A case of fever of unknown origin

Yu-Hung Chen^*

Department of Nuclear Medicine, Buddhist Tzu Chi General Hospital, Hualien.

DOI: 10.4236/crcm.2013.23059                

Abstract

Fever of unknown origin is still a medical challenge. ⁶⁷Ga single photon emission computed tomography/computed tomography images are commonly used to evaluate the final diagnosis of fever of unknown origin. We presented a case of fever of unknown origin undergone ⁶⁷Ga scintigraphy and an intra-abdominal ⁶⁷Ga avid tumor was detected which suspected to be a neoplasm. Further contrast enhanced computed tomography revealed that the lesion was a large renal carbuncle. We concluded that the contrast-enhanced CT or single photon emission computed tomography/computed tomography with contrast enhancement can be performed to further improve diagnostic performance.

Keywords

Fever of Unknown Origin; Gallium Scintigraphy; Neoplasm; Renal Carbuncle

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Knockaert, D.C., Vanderschueren, S. and Blockmans, D. (2003) Fever of unknown origin in adults: 40 years on. Journal of Internal Medicine, 253, 263-275. doi:10.1046/j.1365-2796.2003.01120.x
[2]	Bleeker-Rovers, C.P., van der Meer, J.W. and Oyen, W.J. (2009) Fever of unknown origin. Seminars in Nuclear Medicine, 39, 81-87. doi:10.1053/j.semnuclmed.2008.10.002
[3]	Gaeta, G.B., Fusco, F.M. and Nardiello, S. (2006) Fever of unknown origin: A systematic review of the literature for 1995-2004. Nuclear Medicine Communications, 27, 205-211. doi:10.1097/00006231-200603000-00002
[4]	Knockaert, D.C., Mortelmans, L.A., De Roo, M.C. and Bobbaers, H.J. (1994) Clinical value of gallium-67 scintigraphy in evaluation of fever of unknown origin. Clinical Infectious Disease, 18, 601-605. doi:10.1093/clinids/18.4.601
[5]	Habib, G.S., Masri, R. and Ben-Haim, S. (2004) The utility of gallium scintigraphy in the evaluation of fever of unknown origin. Israel Medical Association Journal, 6, 463-466.
[6]	Roach, P.J., Schembri, G.P., Ho Shon, I.A., Bailey, E.A. and Bailey, D.L. (2006) SPECT/CT imaging using a spiral CT scanner for anatomical localization: Impact on diagnostic accuracy and reporter confidence in clinical practice. Nuclear Medicine Communications, 27, 977-987. doi:10.1097/01.mnm.0000243372.26507.e7
[7]	Bar-Shalom, R., Yefremov, N., Guralnik, L., Keidar, Z., Engel, A., Nitecki, S., et al. (2006) SPECT/CT using 67Ga and 111In-labeled leukocyte scintigraphy for diagnosis of infection. Journal of Nuclear Medicine, 47, 587-594.