Wallace Michael, Tavana Anahita, Leon Amie, Maimone Santo, Letter Haley
Lake Erie College of Osteopathic Medicine, 5000 Lakewood Ranch Blvd, Bradenton, FL 34211, USA.
Department of Radiology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
Radiol Case Rep. 2025 Jul 28;20(10):5172-5177. doi: 10.1016/j.radcr.2025.06.105. eCollection 2025 Oct.
Invasive lobular carcinoma (ILC) presents significant diagnostic challenges due to its subtle presentation on mammography. Its low metabolic activity further limits the detection of metastatic lesions using fluorine-18 (F)-fluorodeoxyglucose-positron emission tomography (FDG-PET). In contrast, F-fluoroestradiol-PET (FES-PET), which targets functional estrogen receptor (ER) expression, enhances visualization of ER-positive metastases. We present a case of metastatic right breast ILC with only subtle suspicious findings on initial mammography and ultrasound. As part of the metastatic workup, FES-PET/MRI was utilized and identified additional metastatic lesions that were not metabolically active on the initial FDG-PET/CT. This case underscores the challenges of ILC detection in breast imaging and highlights the emerging role of FES-PET in its management.
浸润性小叶癌（ILC）因其在乳腺钼靶检查中表现隐匿而带来重大诊断挑战。其低代谢活性进一步限制了使用氟-18（F）-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）检测转移病灶。相比之下，靶向功能性雌激素受体（ER）表达的F-氟雌二醇-PET（FES-PET）可增强ER阳性转移灶的可视化。我们报告一例右乳ILC转移病例，最初的乳腺钼靶和超声检查仅发现细微可疑征象。作为转移灶检查的一部分，采用了FES-PET/MRI，发现了最初FDG-PET/CT上无代谢活性的其他转移病灶。该病例强调了乳腺成像中ILC检测的挑战，并突出了FES-PET在其管理中的新兴作用。
