Humeres Pamela, González Patricio, González Javiera, Prado Elizabeth, Hiplan Enrique
Clínica Santa María, Santiago, Chile,
Medicina Nuclear, Clínica Santa María, Santiago, Chile.
Rev Med Chil. 2017 Apr;145(4):527-532. doi: 10.4067/S0034-98872017000400013.
Signet ring gallbladder carcinoma is a rare aggressive variant of mucinous adenocarcinoma with poor prognosis. Positron emission tomography/computed tomography (PET/CT) with Fluor18 deoxyglucose (F18-FDG) is a useful tool in the staging of gallbladder cancer. We report a 68 years old man with a surgically resected acute cholecystitis, whose biopsy was positive for signet ring cell gallbladder carcinoma. During surgery, locoregional lymph nodes, liver or peritoneal involvement were not detected. A PET/CT was performed for staging, finding multiple hypermetabolic lytic bone lesions. Percutaneous biopsy of a pelvis bone lesion, confirmed a metastasis of the tumor. In this case, the staging with PET/CT allowed the diagnosis of unsuspected bone metastases and was a useful tool for deciding the best site of biopsy for histologic confirmation.
印戒细胞胆囊癌是黏液腺癌中一种罕见的侵袭性亚型,预后较差。18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(PET/CT)是胆囊癌分期的一种有用工具。我们报告一名68岁男性,因急性胆囊炎接受手术切除,其活检印戒细胞胆囊癌呈阳性。手术过程中,未发现局部区域淋巴结、肝脏或腹膜受累。进行PET/CT分期检查,发现多处代谢增高的溶骨性骨病变。对骨盆骨病变进行经皮活检,证实为肿瘤转移。在这种情况下,PET/CT分期有助于诊断未被怀疑的骨转移,并且是决定进行组织学确诊活检最佳部位的有用工具。