Yamanaka-Mitsui Shiori, Oshima Noriko, Odai Tamami, Takao Maki, Wakana Kimio, Akashi Takumi, Tsuchiya Junichi, Miyasaka Naoyuki
Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
Department of Diagnostic Pathology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
Radiol Case Rep. 2024 Jul 31;19(10):4445-4450. doi: 10.1016/j.radcr.2024.07.021. eCollection 2024 Oct.
Ovarian neuroendocrine carcinoma is a rare and aggressive tumor with a poor prognosis. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are often used for diagnosis. However, no specific features exist, and preoperative diagnosis is often difficult. We present a case in which ovarian neuroendocrine carcinoma was diagnosed postoperatively, with the intention to discuss its imaging features on F fluoro-deoxy-glucose positron emission tomography/computed tomography (F-FDG PET/CT). A 70-year-old woman presented to a local hospital with abdominal pain. CT showed a uterine mass and multiple swollen lymph nodes. The mass expanded from the uterus into the left ovarian vessels on dynamic MRI. The SUVmax of the mass and lymph nodes on F-FDG PET/CT were notably elevated to 53.2 and 33.0 respectively. Considering the tumor location and high SUVmax, a malignant uterine tumor was suspected. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omental biopsy, and resection of the left ovarian vessels were performed. Histological examination confirmed that the tumor was a neuroendocrine carcinoma derived from the left ovary. To the best of our knowledge, there are only few reports on the F-FDG uptake in ovarian neuroendocrine carcinomas. Conversely, in other organs, the carcinomas frequently exhibit markedly elevated SUVmax on F-FDG PET/CT. It is possible that ovarian neuroendocrine carcinomas share similar traits, and elevated SUVmax could indicate the potential presence of this histological type.
卵巢神经内分泌癌是一种罕见的侵袭性肿瘤，预后较差。超声、计算机断层扫描（CT）和磁共振成像（MRI）常用于诊断。然而，其并无特异性表现，术前诊断往往困难。我们报告一例卵巢神经内分泌癌术后确诊病例，旨在探讨其在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）上的影像特征。一名70岁女性因腹痛就诊于当地医院。CT显示子宫有肿块及多个肿大淋巴结。动态MRI显示肿块从子宫延伸至左侧卵巢血管。F-FDG PET/CT上肿块及淋巴结的最大标准化摄取值（SUVmax）显著升高，分别为53.2和33.0。考虑到肿瘤位置及高SUVmax，怀疑为恶性子宫肿瘤。遂行全腹子宫切除术、双侧输卵管卵巢切除术、大网膜活检及左侧卵巢血管切除术。组织学检查证实肿瘤为起源于左侧卵巢的神经内分泌癌。据我们所知，关于卵巢神经内分泌癌F-FDG摄取的报道很少。相反，在其他器官，此类癌在F-FDG PET/CT上常表现为SUVmax显著升高。卵巢神经内分泌癌可能具有相似特征，SUVmax升高可能提示存在这种组织学类型。
