Sathekge Tshimogo, Boktor Raef R, Berlangieri Salvatore, Lee Sze Ting
Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa.
Department of Molecular Imaging and Therapy, Austin Health, Melbourne, VIC, Australia.
World J Nucl Med. 2024 Jun 27;23(3):202-206. doi: 10.1055/s-0044-1778708. eCollection 2024 Sep.
Lung cancer with peritoneal carcinomatosis (PC) is a rare disease presentation. The presence of peritoneal disease is a sign of poor prognosis and is hard to diagnose. Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) is becoming more clinically significant in the management of patients with PC. A 60-year-old male presented with nonsmall cell lung cancer (NSCLC) and later showed signs of peritoneal disease on F-FDG PET/CT imaging, which subsequently lead to the diagnoses of PC with histopathology from peritoneal biopsy. The patient showed an excellent initial response to their NSCLC treatment but later presented with PC that was shown by FDG-avid ascites and a soft tissue mass in the pelvic area. The abdominal-pelvic lesions were confirmed cytologically to be peritoneal metastatic disease. F-FDG PET/CT demonstrated value in preoperatively directing biopsy for diagnosing PC in this case of NSCLC. Further, F-FDG PET/CT was useful in the monitoring of disease progression and thus influenced management in this case of NSCLC with PC, which is often challenging to detect and manage.
伴有腹膜癌转移（PC）的肺癌是一种罕见的疾病表现。腹膜疾病的存在是预后不良的标志，且难以诊断。氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）在PC患者的管理中变得越来越具有临床意义。一名60岁男性最初被诊断为非小细胞肺癌（NSCLC），随后F-FDG PET/CT成像显示出腹膜疾病的迹象，随后通过腹膜活检的组织病理学确诊为PC。该患者对其NSCLC治疗最初显示出良好反应，但后来出现了PC，表现为FDG摄取阳性的腹水和盆腔软组织肿块。经细胞学检查确认腹部-盆腔病变为腹膜转移性疾病。在该NSCLC病例中，F-FDG PET/CT在术前指导活检以诊断PC方面显示出价值。此外，F-FDG PET/CT在监测疾病进展方面很有用，因此影响了该伴有PC的NSCLC病例的管理，PC往往难以检测和管理。
