Diagnosis Challenge: Breast Cancer With Synchronous Multiple Stomach, Colon and Bone Metastases on FDG PET/CT

診斷挑戰：FDG PET/CT顯示乳癌合併胃、結腸和骨骼多發轉移

莊紫翎(Tzyy-Ling Chuang) ； 周詩瑾(Shih-Chin Chou) ； 林俊宏(Chun-Hung Lin) ； 王昱豐(Yuh-Feng Wang)

《核子醫學暨分子影像雜誌》 35卷1期 (2022/03) Pp. 28-32

https://doi.org/10.6332/ANMMI.202203_35(1).0004

摘要

A 52-year-old woman had non-painful palpable hard mass 5.5 × 6.0 × 1.0 cm for years, weight loss (from 80 to 62 kg), low appetite, bilateral loin-to-low-back pain, and loose stools for 2 months. Mammography showed right breast stationary upper outer quadrant focal asymmetry and small round calcification, Breast Imaging Reporting and Data System (BIRADS) category 2. ^(18)F-fluorodeoxyglucose positron emission tomography-computed tomography showed uptake in the stomach, cecum, T-colon, right breast, right axillary lymph nodes, axial and appendicular skeletons. Panendoscopy and colonoscopy showed 2 gastric polypoid lesions and subepithelial tumor-like appearance at cecum and T-colon; biopsy at 4 sites showed poorly-differentiated metastatic carcinoma, consistent with the breast origin. Right lateral breast core needle biopsy showed invasive lobular carcinoma.

關鍵字

breast cancer ； colon metastasis ； FDG PET/CT ； invasive lobular carcinoma ； stomach metastasis

並列摘要

一名52歲女性多年來一直有無痛、可觸及的5.5×6.0×1.0公分硬塊；體重減輕（80至62公斤）、食慾不振、雙側腰痛和稀便兩個月。乳房攝影檢查顯示右乳房外上方局部不對稱和小圓形鈣化，乳房攝影報告與資料分析系統（BIRADS）category 2。氟-18去氧葡萄糖正子電腦斷層（FDG PET/CT）顯示胃、盲腸、橫結腸、右側乳房、右側腋窩淋巴結、中軸骨和附肢骨骼的攝取。胃鏡檢查顯示兩處胃息肉樣病變，大腸鏡檢查顯示盲腸和橫結腸上皮下腫瘤樣外觀；四個部位的活檢切片顯示分化不良轉移癌，符合乳房原發的癌症。右側乳房細針切片顯示侵襲性乳小葉癌。

並列關鍵字

乳癌 ； 結腸轉移 ； 氟-18去氧葡萄糖正子電腦斷層 ； 侵襲性乳小葉癌 ； 胃轉移