Lung Adenocarcinoma Staged as an Unknown Primary Presenting with Symptomatic Colon Metastases: Staging by 18F-FDG PET/CT
- PDF / 404,580 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 57 Downloads / 177 Views
CASE REPORT
Lung Adenocarcinoma Staged as an Unknown Primary Presenting with Symptomatic Colon Metastases: Staging by 18F-FDG PET/CT William Makis & Anthony Ciarallo & Javier-A. Novales-Diaz
Received: 7 April 2011 / Accepted: 29 June 2011 / Published online: 16 July 2011 # Korean Society of Nuclear Medicine 2011
Abstract A 66-year-old man, who presented with bright red blood per rectum, was referred for an 18F-FDG PET/CT after colonoscopy showed two suspicious colon masses, which were biopsied to reveal an adenocarcinoma of unknown origin. PET/CT showed two intensely FDG-avid colon masses as well as an unsuspected FDG-avid lung mass, which was biopsied to reveal a primary lung adenocarcinoma. Immunohistochemistry confirmed the two colon metastases were of pulmonary origin. It is extremely rare for lung carcinoma to present with symptomatic colon metastases, with only 11 cases described in the literature. We report the first case of the utility of 18F-FDG PET/CT in staging a patient who presented with symptomatic colon metastases of an unknown primary lung malignancy.
diagnosis. The most common sites of extrapulmonary metastasis are the lymph nodes, liver, adrenal gland, bone, and brain. Colon metastases from lung carcinoma are very rare, and usually occur late in the disease, after the primary diagnosis has been established. In the past 20 years, only 11 cases of symptomatic colon metastases from lung malignancies of all types have been reported in the literature [1– 6]. The use of 18F-FDG PET/CT in the evaluation of a solitary pulmonary nodule is well established in the literature [7–13]. In this rare case, we present the utility of 18 F-FDG PET/CT in detecting an unsuspected lung adenocarcinoma in a patient who presented with symptomatic colon metastases from an unknown primary malignancy.
Case Report Keywords Lung adenocarcinoma . Colon metastases . Fluorodeoxyglucose . FDG . PET/CT
Introduction Lung carcinoma is the leading cause of cancer death, and about 50% of patients have distant metastases at the time of W. Makis (*) Department of Nuclear Medicine, Brandon Regional Health Centre, 150 McTavish Ave E, Brandon, MB R7A 2B3, Canada e-mail: [email protected] A. Ciarallo : J.-A. Novales-Diaz Department of Nuclear Medicine, Royal Victoria Hospital, McGill University Health Centre, 687 Pine Ave West, Floor M2, Montreal, Quebec H3A 1A1, Canada
A 66-year-old man with a smoking history of one pack per week for 40 years presented with bright red blood per rectum. Colonoscopy showed two suspicious masses in the colon, one in the splenic flexure and the other in the upper rectum. The patient was referred for a staging 18 F-FDG PET/CT (Discovery ST, GE Healthcare, Canada) after biopsies and histological evaluation of the colon masses revealed a poorly differentiated adenocarcinoma of unknown origin. Maximum intensity projection (MIP) images (Fig. 1) showed a 6 cm mass in the splenic flexure region of the colon with maximum standardized uptake value (SUVmax) of 10.2 (Fig. 2). There was also a 4.5 cm mass in the rect
Data Loading...
