Cuzzocrea Marco, Paone Gaetano, Treglia Giorgio
Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland.
Diagnostics (Basel). 2023 Aug 10;13(16):2639. doi: 10.3390/diagnostics13162639.
We describe the case of a 67-year-old male patient with a moderately differentiated hepatocellular carcinoma (HCC) of the right liver lobe who underwent [F]fluorocholine positron emission tomography/computed tomography (PET/CT) for staging due to a suspicious lung lesion at previous CT scan. [F]fluorocholine PET/CT showed increased radiopharmaceutical uptake in a liver lesion corresponding to the known HCC. Furthermore, a right pulmonary hilar lesion suspicious for metastatic spread of HCC showed increased radiopharmaceutical uptake. Surprisingly, the histological assessment of the thoracic lesion demonstrated the presence of small cell lung cancer (SCLC). The patient underwent treatment with radiation therapy and chemotherapy for the SCLC and selective internal radiation therapy (SIRT) for the HCC. The patient died after one year due to progressive SCLC. This case demonstrates that coexisting tumors showing increased cell membrane turnover, including SCLC, can be detected by [F]fluorocholine PET/CT. In our case, [F]fluorocholine PET/CT findings influenced the patient management in terms of histological verification and different treatment of the detected lesions.
我们描述了一名67岁男性患者的病例，该患者右肝叶患有中度分化肝细胞癌（HCC），因之前CT扫描发现肺部可疑病变而接受[F]氟胆碱正电子发射断层扫描/计算机断层扫描（PET/CT）进行分期。[F]氟胆碱PET/CT显示，与已知HCC对应的肝脏病变处放射性药物摄取增加。此外，一个怀疑为HCC转移扩散的右肺门病变也显示放射性药物摄取增加。令人惊讶的是，对胸部病变的组织学评估显示存在小细胞肺癌（SCLC）。该患者接受了针对SCLC的放射治疗和化疗以及针对HCC的选择性内照射治疗（SIRT）。患者在一年后因进行性SCLC死亡。该病例表明，包括SCLC在内的具有增加的细胞膜周转率的共存肿瘤可通过[F]氟胆碱PET/CT检测到。在我们的病例中，[F]氟胆碱PET/CT的结果在组织学验证和对检测到的病变进行不同治疗方面影响了患者的管理。
