Hlavatá Z, Pazderová N, Povinec P, Paulíny P, Majidi A, Fiala P, Martanovic P, Sálek T
Department of Internal Medicine, National Cancer Institute, Bratislava, Slovak Republic.
Klin Onkol. 2009;22(6):284-7.
Cancer metastasis to skeletal muscle is very rare. Lung cancer, renal cell carcinoma and malignant melanoma have been reported as the most frequent primary tumours. Diagnosis of muscle metastasis from other primary cancer sites is more than problematic.
In this paper we report a case of metastasis of colorectal cancer in a 44-year-old man who underwent left-sided hemicolectomy due to the tumour mass in his left colic flexure followed by liver metastasectomy and cryocautery of the non-resectable metastasis in the VII segment. Subsequently, the patient was treated with two lines of chemotherapy. However, shortly after initiation of the second chemotherapy line he started to suffer from unbearable pain in the lumbosacral region. Neither a whole spinal cord MRI nor abdominal CT scan and scintigraphy explained the origin of the pain. Finally, PET/CT examination clarified the origin of the pain and showed massive hypermetabolic metastatic lesions in the muscles, further confirmed by autopsy.
Thus, among the different imaging techniques, FDG PET/CT enables the detection of metabolically highly active tumour cells, undetectable by other conventional imaging means.
癌症转移至骨骼肌非常罕见。肺癌、肾细胞癌和恶性黑色素瘤被报道为最常见的原发肿瘤。诊断其他原发癌部位的肌肉转移极具挑战性。
本文报告一例44岁男性的结直肠癌转移病例，该患者因左结肠曲部肿瘤行左侧半结肠切除术，随后进行了肝转移灶切除术及对不可切除的Ⅶ段转移灶进行冷冻治疗。随后，患者接受了两线化疗。然而，在开始第二线化疗后不久，他开始出现腰骶部难以忍受的疼痛。全脊髓磁共振成像、腹部CT扫描及闪烁扫描均无法解释疼痛的来源。最后，PET/CT检查明确了疼痛的来源，并显示肌肉中有大量高代谢转移灶，尸检进一步证实。
因此，在不同的成像技术中，FDG PET/CT能够检测到其他传统成像手段无法检测到的代谢高度活跃的肿瘤细胞。
