Patel Rishi R, Grewal Udhayvir Singh, Xiong Yiqin, Fei Naomi
Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States.
Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.
World J Nucl Med. 2024 Nov 13;24(2):166-168. doi: 10.1055/s-0044-1793833. eCollection 2025 Jun.
Cholangiocarcinoma is an aggressive malignancy arising from the biliary tract epithelium with rising incidence and mortality. Imaging commonly used for diagnostic workup includes computed tomography (CT) scan and magnetic resonance imaging (MRI). Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) scans can be used for investigating equivocal findings on radiographic imaging. Prostate-specific membrane antigen (PSMA) is known to be highly expressed in prostate adenocarcinoma, allowing it to be leveraged as a target for both imaging and radioligand therapy in prostate cancer. However, PSMA is also commonly expressed in other malignancies such as breast cancer, thyroid carcinomas, and head and neck malignancies, which increase the chances of their incidental diagnosis on PSMA PET scans. Biliary tract cancers, including cholangiocarcinoma, are not commonly expected to be incidentally diagnosed on PSMA PET imaging. Here, we describe the case of a patient with known prostate adenocarcinoma who was later incidentally diagnosed with advanced intrahepatic cholangiocarcinoma on PSMA PET/computed tomography (CT). This case highlights the unexpected finding of cholangiocarcinoma on PSMA PET/CT and suggests further investigation into the role of PSMA PET in diagnosing ambiguous cases of cholangiocarcinoma and its potential theranostic applications.
胆管癌是一种起源于胆管上皮的侵袭性恶性肿瘤，其发病率和死亡率呈上升趋势。常用于诊断检查的影像学方法包括计算机断层扫描（CT）和磁共振成像（MRI）。氟-18氟脱氧葡萄糖正电子发射断层扫描（FDG PET）可用于研究影像学检查中不明确的发现。已知前列腺特异性膜抗原（PSMA）在前列腺腺癌中高度表达，使其可作为前列腺癌成像和放射性配体治疗的靶点。然而，PSMA在其他恶性肿瘤如乳腺癌、甲状腺癌和头颈部恶性肿瘤中也普遍表达，这增加了在PSMA PET扫描中偶然诊断出这些肿瘤的几率。包括胆管癌在内的胆道癌通常不会在PSMA PET成像中被偶然诊断出来。在此，我们描述了一例已知患有前列腺腺癌的患者，其后来在PSMA PET/计算机断层扫描（CT）中偶然被诊断出患有晚期肝内胆管癌。该病例突出了在PSMA PET/CT上意外发现胆管癌的情况，并建议进一步研究PSMA PET在诊断胆管癌疑难病例中的作用及其潜在的诊疗应用。
