case_images: PMC11259480_01
case_images: Skin findings noted in right hip on physical exam.
case_images: jchim-14-03-072f1.jpg
case_images: PMC11259480_01_jchim-14-03-072f1.jpg
case_images: f1-jchim-14-03-072
case_images: Physical examination revealed indurated erythematous nodules localized to the hips (Fig. 1).
case_images: Total body fluorodeoxyglucose positron emission tomography (PET)/CT scan. Panel A: Anteroposterior view. Panel B: Right lateral view. Noted diffuse moderate FDG uptake in the subcutaneous adipose tissue of bilateral gluteal regions greatest laterally extending inferiorly to the level of the hips and upper thighs, measuring on the order 31 cm in superior to inferior extent bilaterally. The left-side area has a SUV max of 4.9, and the right-side area has SUV max of 5.4.
case_images: jchim-14-03-072f2.jpg
case_images: PMC11259480_01_jchim-14-03-072f2.jpg
case_images: f2-jchim-14-03-072
case_images: A (84.2 mcg/dL, Ref -62 mcg/dL), normal 25-hydroxyvitamin D (30.5 ng/mL), low PTHrP (<2 pmol/L), mildly elevated serum angiotensin-converting enzyme (91 U/L), a negative QuantiFERON-TB gold, and marked elevation of 1,25-dihydroxyvitamin D (138 pg/mL). A whole-body PET-CT demonstrated moderate FDG uptake within the subcutaneous adipose tissue of the lateral aspect of bilateral gluteal regions from above the iliac crests to the upper thighs (Fig. 2).