Clavicular Osteoradionecrosis With 99mTc-FAPI-46 Uptake in a Patient With Breast Cancer.
Mohammad Ahmadi, Mohammad Hadi Samadi, Ehsan Soltani et al.
✦ AI-curated · Sources linked
Case in brief
A 65-year-old woman with a history of right breast cancer treated with mastectomy and chemoradiotherapy later developed cervical and supraclavicular metastatic disease and a left supraclavicular ulcer. During 99mTc-FAPI-46 imaging, a focal uptake at the left thoracic inlet was seen. CT showed geographic osteolysis with irregular sclerotic margins at the medial left clavicle, consistent with postradiotherapy osteonecrosis rather than a metastatic lesion.
What made this case unusual
The clavicular osteoradionecrosis showed focal 99mTc-FAPI-46 uptake, creating a potential imaging mimic of metastatic disease.
Diagnostic / clinical pearl
Interpret focal 99mTc-FAPI-46 uptake alongside CT morphology and treatment history; postradiotherapy osteonecrosis can account for uptake that might otherwise be mistaken for metastasis.