- 期刊
Use of F-18 FDG PET/CT for Preoperative and Recurrent Assessment of Leiomyosarcoma of the Inferior Vena Cava: A Case Report and Literature Review
利用正子電腦斷層作為下腔靜脈平滑肌惡性肉瘤之術前及復發評估：病例報告及文獻回顧
摘要
Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare disease, and surgery is the first consideration with curative intent. In terms of this situation, the importance of operability and surgical planning cannot be overemphasized. As to one case with a 36-years-old female patient who experienced swollen abdomen and abdominal pain, with abdominal computer tomography (CT), it showed a huge tumor occupying the caudate lobe of the liver with left portal vein and inferior vena cava (IVC) involvement. Later, F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) was applied for preoperative survey, and it revealed that hepatic lobes nearby IVC involved. Extensive excision with prosthetic replacement of the inferior vena cava was done then, and the pathological result disclosed LMS of IVC to be with liver metastasis. Unfortunately, seven months later after previous surgery, follow-up abdominal CT showed recurrence of two large tumors were at lesser sac and subphrenic space. We used F-18 FDG PET/CT again and found it peripherally increased FDG uptake in both vascular prosthesis and the tumors. Second surgery for removal of the recurrent tumors was performed, and there were solid component and serosanguineous fluid inside the tumors. In this case, F-18 FDG PET/CT helped us exclude the possibility of distant metastasis and make a surgical planning properly.
並列摘要
發生於下腔靜脈之平滑肌惡性肉瘤相當罕見。依現況，考量到治癒的可能性，以手術為優先選項，能否手術及術前評估計畫顯得相當重要。一名36歲女性因腹脹及腹痛就診，其腹部電腦斷層發現一巨大腫瘤侵犯肝臟尾葉、門靜脈左支及下腔靜脈。以正子電腦斷層掃描作術前評估，發現圍繞下腔靜脈兩側肝葉有放射性活性增加。之後實施廣泛性腫瘤切除及下腔靜脈人工血管置換，病理結果顯示為下腔靜脈之平滑肌惡性肉瘤併肝臟侵犯。術後七月，於門診追蹤之電腦斷層疑似腹腔復發腫瘤，二度安排正子電腦斷層顯示腫瘤邊緣放射性活性增加，隨即再次進行腫瘤切除，並於術中發現腫瘤除實質部分外，內含漿液血色液體。正子電腦斷層可以幫助我們排除遠端轉移的可能性，且訂定合適的手術計畫。
延伸閱讀
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