A Rare Case of Orbital Metastasis from Invasive Lobular Carcinoma: Challenges of 18F-FDG PET/CT and the Search for Consensus on Imaging.

IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Marjorie Lam, Johnny Yang, Vani Vijayakumar
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引用次数: 0

Abstract

Invasive lobular carcinoma (ILC) frequently underlies orbital metastasis. A 74-y-old woman, who was current with mammograms and had no cancer history, presented to her ophthalmologist with visual complaints and was found to have metastatic ILC. MRI was contraindicated, and an 18F-FDG PET/CT scan revealed a mildly hypermetabolic right orbital mass and low uptake in the left subareolar breast, suggestive of metastatic ILC. Small studies have found that in ILC, 16α-18F-fluoroestradiol and fibroblast activation protein inhibitors are more avid than 18F-FDG. There is currently no consensus regarding imaging for ILC. Many people have contraindications to MRI, and the higher rate of false-negative findings on mammography for ILC than for other breast cancers makes this patient population more vulnerable to inaccurate staging, incorrect assessment of tumor burden, and, consequently, insufficient treatment. We provide this interesting case to highlight the potential of 18F-fluoroestradiol PET/CT and fibroblast activation protein inhibitors over 18F-FDG in this breast cancer subtype.

一例罕见的浸润性肺叶癌眼眶转移病例:18F-FDG PET/CT 的挑战与寻求成像共识。
浸润性小叶癌(ILC)经常发生眼眶转移。一位 74 岁的妇女一直有乳房 X 光检查,也没有癌症病史,她因视力不适到眼科医生处就诊,发现患有转移性 ILC。核磁共振检查是禁忌症,18F-FDG PET/CT 扫描显示右眼眶肿块轻度高代谢,左侧乳晕下乳腺低吸收,提示转移性 ILC。有小型研究发现,在 ILC 中,16α-18F-氟雌二醇和成纤维细胞活化蛋白抑制剂比 18F-FDG 的摄取率更高。关于 ILC 的成像,目前还没有达成共识。很多人都有核磁共振成像禁忌症,而且与其他乳腺癌相比,ILC 的乳腺 X 线造影检查假阴性率更高,这使得这类患者更容易出现分期不准确、肿瘤负荷评估不正确的情况,从而导致治疗不充分。我们提供了这个有趣的病例,以强调 18F- 氟雌二醇 PET/CT 和成纤维细胞活化蛋白抑制剂比 18F-FDG 在这种乳腺癌亚型中更有潜力。
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来源期刊
Journal of nuclear medicine technology
Journal of nuclear medicine technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.90
自引率
15.40%
发文量
57
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