Doroudinia Abtin, Mehrian Payam, Dorudinia Atosa, Kaghazchi Fatemeh
PET/CT, Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran.
Radiology, Telemedicine Research Center (TRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, The Islamic Republic of Iran.
BMJ Case Rep. 2019 Jan 22;12(1):e226802. doi: 10.1136/bcr-2018-226802.
Rectal carcinoma with metastasis to skeletal muscle is a rare finding. According to literature review, 17 cases of skeletal muscle metastasis from colorectal carcinoma have been documented where only six cases were rectal carcinomas.We discuss a case of a middle-aged man with a known history of high-grade mucinous adenocarcinoma of the rectum, status post abdominoperineal resection followed by adjuvant radiotherapy and chemotherapy. During the planned chemotherapy course, a right proximal thigh subcutaneous mass was incidentally found which on subsequent biopsy proved to be metastatic from rectal primary site. On subsequent 18F-FDG (Fluorodeoxyglucose) positron emission tomography (PET)/CT scan after completion of chemotherapy for the purpose of treatment response evaluation, only FDG-avid lesion was residual right proximal thigh metastatic mass without involvement of other common sites, such as liver and lung. In this case, the 18F-FDG-PET/CT scan was able to exclude additional metastatic sites and also evaluate the patient's treatment response.
伴有骨骼肌转移的直肠癌是一种罕见的发现。根据文献综述，已记录了17例结直肠癌发生骨骼肌转移的病例，其中仅有6例为直肠癌。我们讨论一例中年男性病例，其有直肠高级别黏液腺癌病史，行腹会阴联合切除术后接受辅助放疗和化疗。在计划的化疗疗程中，偶然发现右大腿近端皮下肿块，后续活检证实其为直肠原发部位的转移灶。在完成化疗后，为评估治疗反应而进行的后续18F-FDG（氟脱氧葡萄糖）正电子发射断层扫描（PET）/CT检查中，仅FDG摄取阳性的病灶为右大腿近端残留的转移肿块，未累及其他常见部位，如肝脏和肺。在此病例中，18F-FDG-PET/CT扫描能够排除其他转移部位，并评估患者的治疗反应。
