Shida M, Murakami M, Tsukada H, Ishiguro Y, Kikuchi K, Yamashita E, Kajiwara H, Yasuda M, Ide M
Department of Obstetrics & Gynecology, Tokai University School of Medicine, Kanagawa 159-0198, Japan.
Int J Gynecol Cancer. 2007 Jan-Feb;17(1):285-90. doi: 10.1111/j.1525-1438.2006.00778.x.
Leiomyomas of uterus are common disease in gynecology. It is important to differentiate leiomyoma from leiomyosarcoma at the decision of treatment methods, especially in the case of the conservative treatment for uterine leiomyoma. But the exact diagnosis of benign leiomyoma is often difficult due to the degeneration of myoma by imaging modalities including magnetic resonance imaging. Recently, whole-body positron emission tomography (PET) using F-18 fluorodeoxyglucose (FDG) has been used for a diagnosis of malignant tumors. There is a growing body of evidence for the use of FDG in differentiating malignant from benign disease. But optimal utilization in gynecology remains unclear. Our case represents increased uptake of FDG in myomatous uterus, which is pathologically confirmed benign leiomyoma by the hysterectomy. Immunohistochemical analysis of glucose transporter-1 showed positive in endometrial tissue and negative in leiomyoma. Our case indicates that myomatous uterus in premenopausal women shows the potential pitfall of a positive result of FDG-PET.
子宫平滑肌瘤是妇科常见疾病。在决定治疗方法时,尤其是对于子宫平滑肌瘤的保守治疗,区分平滑肌瘤与平滑肌肉瘤很重要。但由于包括磁共振成像在内的影像学检查显示肌瘤发生变性,准确诊断良性平滑肌瘤往往很困难。近年来,使用F-18氟脱氧葡萄糖(FDG)的全身正电子发射断层扫描(PET)已用于恶性肿瘤的诊断。越来越多的证据表明FDG可用于鉴别恶性与良性疾病。但在妇科的最佳应用仍不明确。我们的病例显示子宫肌瘤中FDG摄取增加,经子宫切除术后病理证实为良性平滑肌瘤。葡萄糖转运蛋白-1的免疫组化分析显示在子宫内膜组织中呈阳性,在平滑肌瘤中呈阴性。我们的病例表明,绝经前女性的子宫肌瘤显示出FDG-PET结果呈阳性的潜在陷阱。