Hayashi Kumiko, Fujioka Tomoyuki, Hara Masatake, Kumaki Yuichi, Oda Goshi, Yamaga Emi, Mori Mio, Ohnishi Iichiroh, Kubota Kazunori, Nakagawa Tsuyoshi
Department of Breast Surgery, Tokyo Medical and Dental University Hospital, Tokyo 113-8510, Japan.
Department of Diagnostic Radiology, Tokyo Medical and Dental University Hospital, Tokyo 113-8510, Japan.
Diagnostics (Basel). 2022 Sep 25;12(10):2308. doi: 10.3390/diagnostics12102308.
A woman in her 70s was diagnosed with left breast cancer and left axillary lymph node metastasis by an ultrasound-guided biopsy. F-FDG-PET/CT showed strong FDG accumulation in the tumor in the left breast and a left axillary lymph node. Neoadjuvant chemotherapy (NAC) was administered in combination with a G-CSF injection to prevent febrile neutropenia. The post-treatment F-FDG-PET/CT showed the disappearance of the left breast tumor and left axillary lymph node and revealed a solitary new area of strong FDG accumulation in the sternum. To rule out the possibility of sternal metastasis, a sternal biopsy was performed at the same time as surgery, which revealed no malignant findings. Although very rare, focal uptake on F-FDG-PET/CT performed after anticancer drug therapy with G-CSF may mimic a solitary bone metastasis. A bone biopsy may be a useful technique to avoid an immediate misdiagnosis of bone metastasis.
一名70多岁的女性经超声引导活检被诊断为左乳腺癌伴左腋窝淋巴结转移。F-FDG-PET/CT显示左乳腺肿瘤和左腋窝淋巴结有强烈的FDG摄取。给予新辅助化疗（NAC）并联合注射粒细胞集落刺激因子（G-CSF）以预防发热性中性粒细胞减少。治疗后的F-FDG-PET/CT显示左乳腺肿瘤和左腋窝淋巴结消失，并在胸骨处发现一个孤立的新的强烈FDG摄取区域。为排除胸骨转移的可能性，在手术的同时进行了胸骨活检，结果未发现恶性病变。尽管非常罕见，但在使用G-CSF进行抗癌药物治疗后进行的F-FDG-PET/CT上的局灶性摄取可能会模拟孤立性骨转移。骨活检可能是一种有用的技术，可避免立即误诊为骨转移。
