van Westreenen Henderik L, Westerterp Marinke, Jager Pieter L, van Dullemen Hendrik M, Sloof Gerrit W, Comans Emile F I, van Lanschot J Jan B, Wiggers Theo, Plukker John Th M
Department of Surgery, University of Groningen and University Medical Center Groningen, The Netherlands.
J Nucl Med. 2005 Aug;46(8):1321-5.
Because of improvements in diagnostic technology, the incidental detection of synchronous primary tumors during the preoperative work-up of patients with esophageal cancer has increased. The aim of this study was to determine the rate and clinical relevance of synchronous neoplasms seen on (18)F-FDG PET in staging of esophageal cancer.
From January 1996 to July 2004, 366 patients with biopsy-proven malignancy of the esophagus underwent (18)F-FDG PET for initial staging. This series of patients was retrospectively reviewed for the detection of synchronous primary neoplasms.
Twenty synchronous primary neoplasms (5.5%) were identified in 366 patients. Eleven neoplasms were in the colorectum, 5 in the kidney, 2 in the thyroid gland, 1 in the lung, and 1 in the gingiva. One of the thyroid lesions and the lung lesion were erroneously interpreted as metastases, leading to incorrect upstaging of the esophageal tumor.
(18)F-FDG PET detected unexpected synchronous primary neoplasms in 5.5% of patients with esophageal cancer. Sites of pathologic (18)F-FDG uptake should be confirmed by dedicated additional investigations before treatment, because synchronous neoplasms may mimic metastases.
由于诊断技术的改进，食管癌患者术前检查期间偶然发现同步原发性肿瘤的情况有所增加。本研究的目的是确定在食管癌分期中（18）F-FDG PET上看到的同步肿瘤的发生率和临床相关性。
从1996年1月至2004年7月，366例经活检证实为食管恶性肿瘤的患者接受了（18）F-FDG PET进行初始分期。对这一系列患者进行回顾性研究以检测同步原发性肿瘤。
在366例患者中发现了20例同步原发性肿瘤（5.5%）。11例肿瘤位于结直肠，5例位于肾脏，2例位于甲状腺，1例位于肺，1例位于牙龈。其中1例甲状腺病变和1例肺部病变被错误地解释为转移，导致食管癌分期错误上调。
（18）F-FDG PET在5.5%的食管癌患者中检测到意外的同步原发性肿瘤。在治疗前，应通过专门的额外检查确认病理性（18）F-FDG摄取部位，因为同步肿瘤可能类似转移瘤。
