Fluorodeoxyglucose-Positron Emission Tomography/Computered Tomography for Detection of Recurrent Lacrimal Gland Adenoid Cystic Carcinoma-A Case Report

全身性正子造影併斷層掃描在囊狀淚腺癌復發病灶的診斷應用－病例報告

胡鴻琳(Hung-Lin Hu) ； 畢勇賢(Youn-Shen Bee) ； 林睦秋(Muh-Chiou Lin) ； 許淑娟(Shwu-Jiuan Sheu)

《中華民國眼科醫學會雜誌》 50卷1期 (2011/04) Pp. 193-198

https://doi.org/10.30048/ACTASOS.201104.0029

摘要

目的：報告一囊狀淚腺癌患者，使用全身性正子造影併斷層掃描追蹤其復發性病灶之案例。方法：病例報告。結果：此篇文章描述一位三十三歲男性自述右眼眼皮下垂併腫脹疼痛，於是至醫院求診，經腦部斷層掃描及核磁共振檢查，初步為右眼發炎性假性腫瘤（inflammatory pseudotumor）給予類固醇治療，症狀逐漸緩解。治療後三週，右眼疼痛復發，施予切片檢查顯示為惡性，全身檢查（包含全身性正子造影併斷層掃描）無其他遠處轉移。因此安排廣泛性右側淚腺腫瘤切除及放射性治療。術後追蹤四個月，病人抱怨頭痛合併右前額感覺麻痺，腦部斷層掃描無法區分右前額影像為放射線治療後反應或是腫瘤復發，於是再次安排全身性正子造影併斷層掃描做進一步檢查，結果顯示局部腫瘤復發併遠處轉移。結論：正子造影併斷層掃描較傳統電腦斷層更早診斷囊狀淚腺癌的復發性病灶。

並列摘要

Purpose: To report a case of recurrent lacrimal gland adenoid cystic carcinoma detected by Fluorodeoxyglucose-Positron Emission Tomography/Computer Tomography (FDG-PET/CT). Method: Case report. Result: A 33 year-old male presented with right eyelid droop, followed by periorbital pain and eyelid swelling. Brain CT and MRI suggested an inflammatory pseudotumor. Steroid was given, which relieved his discomfort. Ocular pain recurred three weeks later after steroid treatment. Biopsy of lacrimal gland revealed poorly differentiated malignancy. No metastasis was detected by systemic survey, including FDG-PET/CT. Radical excision of right lacrimal gland tumor was performed, and the pathology demonstrated adenoid cystic carcinoma. He then received orbital radiotherapy. Four months after surgery, headache and right frontal area numbness were noted. Brain CT delineated either post-therapeutic change or recurrent tumor. The following FDG-PET/CT showed local recurrence with distant metastasis. One month later, Brain CT demonstrated brain metastasis and he expired ten days later. Conclusions: FDG-PET/CT may become a better tool than CT for early detection of recurrent lacrimal gland malignancy.

並列關鍵字

Lacrimal Gland Adenoid Cystic Carcinoma ； FDG-PET/CT