- 期刊
Utility of Fluorine-18-Fluorodeoxyglocuse Metabolism to Differentiate Primary Hepatocellular Carcinoma and Secondary Liver Metastasis from Breast Cancer: A Case Report
利用氟－18-去氧葡萄糖的代謝來區分原發性肝細胞癌及乳癌肝臟轉移之鑑別診斷：一病例報告
摘要
乳癌爲女性最常見的癌症，而肝臟是乳癌僅次於骨骼和肺臟的最易轉移器官。另一方面，肝細胞癌也是最常見的癌症之一。目前常用於偵測原發性和次發性之肝臟腫瘤的工具包括有肝血液檢查、超音波、電腦斷層和磁振造影。而隨著正子斷層掃描機器的普及，越來越多的醫院機構開始採用正子斷層掃描來評估原發性或次發性的肝臟腫瘤。我們報告一個接受治療後的乳癌病人，她在腹部超音波的追蹤檢查中發現肝臟病灶，磁振造影亦顯示疑似肝臟急性病灶。因此，她接受了全身正子電腦斷層掃描進行再分期。正子掃描結果顯示其肝臟腫瘤的葡萄糖攝取呈輕微增加，其表現比較傾向於原發性的肝細胞癌。最後病人接受肝臟穿刺檢查，病理報告顯示爲肝細胞癌。雖然正子掃描在原發性肝細胞癌的偵測率並不高，但由於部份肝細胞癌的葡萄糖代謝表現可能明顯不同於乳癌肝藏轉移的高葡萄糖代謝表現，所以對於鑑別診斷此二者，正子斷層掃描仍有其價值存在。
並列摘要
Breast cancer is the most common cancer in females. The liver is the third most common site for breast cancer to spread to after bone and lung. On the other hand, the primary hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The conventional tools to evaluate primary HCC and liver metastases include liver blood tests, abdominal US, CT and MRI. With the increased availability of PET, more institutions performed FDG PET scan to evaluate either primary or metastatic lesions of liver. We present a case with breast cancer status post treatment, who had a hepatic lesion detected by follow-up US and liver metastasis was suspected. And then, she underwent FDG PET scan for restaging, which revealed a faintly hypermetabolic lesion in liver and primary HCC was more favored than metastasis. The final diagnosis by liver biopsy disclosed HCC. Although FDG PET has low sensitivity in detection of HCC, it may be useful in differentiation of HCC and liver metastasis owing to the unlike images presenting between them.
延伸閱讀
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