Fu Jingjing, Song Jinhua, Zhao Youcai, Wang Feng, Shao Guoqiang
Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 21006, P.R. China.
Department of Intervention, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 21006, P.R. China.
Mol Clin Oncol. 2017 Feb;6(2):197-200. doi: 10.3892/mco.2016.1119. Epub 2016 Dec 28.
Peripheral primitive neuroectodermal tumors (pPNETs) are a group of aggressive neoplasms that are most commonly encountered in pediatric patients and may be located in the abdomen, pelvis, thoracopulmonary region and, rarely, in the head and neck region. pPNETs in adults are extremely rare. The present study reports a case of pPNET located in the hip muscles with bone metastasis. The patient was a 44-year-old woman who complained of progressive pain and swelling with a mass near the left hip. Computed tomography (CT) and enhanced CT revealed a soft tissue mass lesion in the hip muscle group measuring 4.3×4.3×4.4 cm. The lesion was ill-defined, heterogeneous, exhibiting mild post-contrast enhancement. There was a large number of bent neovessels and several branches from the left internal iliac artery and deep femoral artery on enhanced CT scan. Triple-phase dynamic imaging with integrin αβ-targeted Tc-3P-RGD as the radiotracer revealed increased blood perfusion and radiotracer aggregation in the large, ill-defined, heterogeneous, hypodense mass and adjacent bone. The patient was suspected of having pPNET with bone metastasis, which was confirmed by histological examination of a sample obtained by needle aspiration. Due to the high blood perfusion of primary pPNETs and high RGD uptake by the primary and metastatic lesions, chemoembolization and anti-angiogenic therapy were considered to be the optimal therapeutic choice. This also suggested that Lu-labeled RGD has great potential for the targeted treatment of pPNETs with multiple metastases.
外周原始神经外胚层肿瘤（pPNETs）是一组侵袭性肿瘤，最常见于儿科患者，可位于腹部、骨盆、胸肺区域，很少见于头颈部区域。成人pPNETs极为罕见。本研究报告了1例位于髋部肌肉并伴有骨转移的pPNETs病例。患者为一名44岁女性，主诉左髋附近渐进性疼痛、肿胀并伴有肿块。计算机断层扫描（CT）及增强CT显示髋部肌群有一软组织肿块，大小为4.3×4.3×4.4 cm。该病灶边界不清，密度不均，增强扫描后呈轻度强化。增强CT扫描显示有大量迂曲的新生血管以及来自左髂内动脉和股深动脉的几条分支。以整合素αβ靶向的Tc-3P-RGD为放射性示踪剂的三相动态成像显示，在边界不清、密度不均的大的低密度肿块及相邻骨质中血流灌注增加且放射性示踪剂聚集。该患者被怀疑患有伴有骨转移的pPNETs，经针吸活检组织学检查得以证实。由于原发性pPNETs血供丰富且原发灶和转移灶对RGD摄取较高，化疗栓塞和抗血管生成治疗被认为是最佳治疗选择。这也提示，Lu标记的RGD在靶向治疗多发转移的pPNETs方面具有巨大潜力。
