Unusually Metastatic Pattern with Extensive Subcutaneous Metastases in 18F-FDG PET/CT in a Patient with Recurrent Cervical Cancer

復發性子宮頸癌罕見之廣泛性皮下組織轉移之氟－18-去氧葡萄糖正子掃描影像的病例報告

陳永龍(Yung-Lung Chen) ； 林昆儒(Kun-Ju Lin) ； 周宏學(Hung-Hsueh Chou) ； 閻紫宸(Tzu-Chen Yen)

《核子醫學雜誌》 20卷2期 (2007/06) Pp. 93-99

https://doi.org/10.6332/ANMS.2002.005

摘要

一名子宮頸上皮鱗狀細胞癌、FIGO分期第IB2期的45歲女性病患，接受放射線治療合併化學治療後規則在婦產科門診追蹤。她於追蹤時發現兩側頸部林巴結腫大，電腦斷層婦描顯示除頸部淋巴節外有其他更多疑似轉移的病灶。因此被轉介至本院正子中心進行進一步惡性腫瘤的評估。氟－18-去氧葡萄糖正子電腦斷層造影意外地發現多處皮下軟組織有葡萄糖代謝增加之病灶。回顧文獻，子宮頸癌在接受合併放射線與化學治療後以皮下軟組織轉移來複發的情況相當罕見，且多數爲腺癌。根據PubMed文獻，以氟－18-去氧葡萄糖正子電腦斷層造影發現子宮頸癌合併皮下軟組織轉移病例，目前爲止只有一例被報導出來。本病例爲另外一例複發性子宮頸癌的女性患者，利用正子電腦斷層做”metabolic biopsy”時，發現到比電腦斷層更多、更廣泛的皮下軟組織轉移。

關鍵字

氟－18-去氧葡萄糖正子電腦斷層造影 ； 子宮頸癌 ； 皮下軟組織轉移

並列摘要

A 45-year-old woman was a victim of squamous cell carcinoma of uterine cervix and had received concurrent chemo-radiation therapy (CCRT) as her primary definite treatment for FIGO stage IB2 disease. She was found to have enlarged lymph nodes at right neck and left supraclavicular area after a disease-free interval of 5 months. Whole body CT revealed multiple suspicious metastases in lung, adrenal glands, and the subcutaneous area at the left lower back in addition to the lymph nodes at right neck and left supraclavicular area. Therefore, she was referred to our positron emission tomography (PET) center for ”metabolic biopsy” to further confirm the nature of these unusual lesions especially those in lung and adrenal glands. Extensively multiple 18F-FDG-avid lesions in the subcutaneous areas were observed during this examination. Subcutaneous recurrent lesions in cervical cancer after CCRT were uncommon, and most were adenocarcinoma. According to the literatures from PubMed, only one was reported in cervical cancer by PET. This was another case of recurrent cervical cancer found to have multiple subcutaneous nodules when undergoing PET/CT.

並列關鍵字

18F-FDG PET ； cervical cancer ； subcutaneous metastasis