Malaty Shiva, Bastian Craig M, Ramirez-Cibes Ines, Shahlapour Mahmood, Dhillon Wishwdeep
Internal Medicine, HonorHealth Medical Center, Scottsdale, USA.
Hematology and Oncology, Arizona College of Osteopathic Medicine, Glendale, USA.
Cureus. 2020 Jul 28;12(7):e9449. doi: 10.7759/cureus.9449.
Immunotherapy has revolutionized the treatment of malignant melanomas. Immunotherapy is associated with multi-system toxicities, which are referred to as immune-related adverse events (irAEs). Positron emission tomography (PET) with fluorodeoxyglucose (FDG) and CT is the preferred imaging modality to monitor disease progression in melanoma. FDG uptake by a sarcoid-like reaction (SLR) can mimic cancer progression, thereby posing a diagnostic and therapeutic dilemma. We present the case of a 39-year-old patient with malignant melanoma on immunotherapy who presented with PET scan findings of adenopathy with increased uptake. This case highlights the challenges in interpreting PET scan in the setting of an SLR.
免疫疗法彻底改变了恶性黑色素瘤的治疗方式。免疫疗法与多系统毒性相关，这些毒性被称为免疫相关不良事件（irAEs）。使用氟脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）和CT是监测黑色素瘤疾病进展的首选成像方式。类肉瘤样反应（SLR）摄取FDG可模拟癌症进展，从而造成诊断和治疗困境。我们报告一例39岁接受免疫治疗的恶性黑色素瘤患者，其PET扫描结果显示淋巴结病且摄取增加。该病例突出了在SLR情况下解读PET扫描的挑战。
