Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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A Case of Metastatic Tonsillar Lesion Showing Increased FDG Uptake in the Patient with Advanced Hepatocellular Carcinoma

진행성 간암 환자에서 편도 전이에 FDG 섭취증가를 보인 예

  • Park, Jung-Mi (Departments of nuclear medicine, Bucheon Hospital Soonchunhyang University College of Medicine) ;
  • Kim, Hee-Kyung (Departments of pathology, Bucheon Hospital Soonchunhyang University College of Medicine) ;
  • Kim, Sang-Gyune (Departments of internal medicine, Bucheon Hospital Soonchunhyang University College of Medicine) ;
  • Kim, Young-Seok (Departments of internal medicine, Bucheon Hospital Soonchunhyang University College of Medicine)
  • 박정미 (순천향대학교 부천병원 핵의학과) ;
  • 김희경 (순천향대학교 부천병원 병리과) ;
  • 김상균 (순천향대학교 부천병원 내과) ;
  • 김영석 (순천향대학교 부천병원 내과)
  • Published : 2008.02.29
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Abstract

A 65 year-old man with hepatocellulcar carcinoma (HCC) admitted to treat left lower leg swelling and pus discharge suspecting osteomyelitis. MRI of his lower leg revealed the bone metastasis. Whole body FDG PET/CT additionally detected left shoulder and right ilium metastasis. Hematemesis suddenly developed in this patient after 3 weeks. Metastasis of right tonsil was histologically proven. When we reviewed his FDG PET/CT, there was asymmetric mild hypermetabolism in the right tonsil. When focal hypermetabolism is shown in the organ physiologically taking glucose up such as tonsil, we should cautiously assess whole body PET/CT in the examination of distant metastasis. We present a patient with multiple distant metastasis including tonsil from HCC showing increased FDG uptake with the literature review.

Keywords

References

  1. Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, et al. Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. J Nucl Med 1992;33:333-9
  2. Khan MA, Combs CS, Brunt EM, Lowe VJ, Wolverson MK, Solomon H, et al. Positron emission tomography scanning in the evaluation of hepatocellular carcinoma. J Hepatol 2000;32:792-7 https://doi.org/10.1016/S0168-8278(00)80248-2
  3. Trojan J, Schroeder O, Raedle J, Baum RP, Hermann G, Jacobi V, et al. Fluorine-18 FDG positron emission tomography for imaging of hepatocellular carcinoma. Am J Gastroenterol 1999;94:3314-9 https://doi.org/10.1111/j.1572-0241.1999.01544.x
  4. Goldberg MA, Mayo-Smith WW, Papaicolaou N, Fischman AJ, Lee MJ. FDG PET characterization of renal masses: preliminary experience. Clin Radiol 1997;52:510-5 https://doi.org/10.1016/S0009-9260(97)80327-3
  5. Kim BT, Kim Y, Lee KS, Yoon SB, Cheon EM, Kwon OJ, et al. Localized form of bronchioloalveolar carcinoma: FDG PET findings. AJR 1998;170:935-9 https://doi.org/10.2214/ajr.170.4.9530038
  6. Stahl A, Ott K, Weber WA, Becker K, Link T, Siewert JR, et al. FDG-PET imaging locally advanced gastric carcinomas:correlation with endoscopic and histological findings. Eur J Nucl Med 2003;30:288-95 https://doi.org/10.1007/s00259-002-1029-5
  7. Weber G, Cantero A. Glucose-6-phosphase activity in normal, precancerous, and neoplastic tissues. Cancer Res 1995;15:105-8
  8. Callagher BM, Flower JS, Gutterson NI, MacGregor PR, Wan CN, Wolf AP. Metabolic trapping as a principle of radiopharmaceutical design: some factors responsible for the biodistribution of 18F 2-deoxy-2-fluoro-D-glucose. J Nucl Med 1978;19:1154-61
  9. Nakashima RA, Paggi MG, Scott LJ, Pedersen PL. Purification and characterization of a bindable form of mitochondrial bound hexokinase from the highly glycolytic AS-30D rat hepatoma cell line. Cancer Res 1988;48:913-9
  10. Torizuka T, Tamaki N, Inokuma T, Magata Y, Sasayama S, Yonekura Y, et al. In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET. J Nucl Med 1995;36:1811-7
  11. Shiomi S, Nishiguchi S, Ishizu H, Iwata Y, Sasaki N, Tamori A, et al. Usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose for predicting outcome in patients with hepatocellular carcinoma. Am J Gastroenterol 2001;96:1877-80 https://doi.org/10.1111/j.1572-0241.2001.03888.x
  12. Sugiyama M, Sakahara H, Torizuka T, Kanno T, Nakamura F, Futatsubashi M, et al. 18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma. J Gastroenterol 2004;39:961-8 https://doi.org/10.1007/s00535-004-1427-5
  13. Chen YK, Hsieh DS, Liao CS, Bai CH, Su CT, Shen YY, et al. Utility of FDG-PET for investigating unexplained serum AFP elevation in patients with suspected hepatocellular carcinoma recurrence. Anticancer Res 2005;25:4719-25
  14. Nakahara K, Matsuo S, Takeuchi H, Ikoma H. A case of hepatocellular carcinoma metastatsizing to the palatine tonsil. Yonago Acta Media 1999;42:217-20
  15. Tanaka N, Toya M, Koyanagi Y. Tonsillar metastasis from carcinoma of the stomach: report of a case. Jibi To Rinsho 1981;27:811-4
  16. Kanazawa H, Sato K, Gingival metastasis from primary hepatocellular carcinoma: report of a case and review of literature. J oral Maxillofac Surg 1989;47:987-90 https://doi.org/10.1016/0278-2391(89)90385-6
  17. Oida Y, Ishhi M, Dowaki S, Tobita K, Ohtani Y, Imaizumi T, et al. Hepatocellular carcinoma with metastasis to the pharynx: report of a case. Tokai J Exp Clin Med 2005:30;31-4
  18. Gallo A, Pescarmona E, Crupi J, Corsetti GL, Vincentiis DM. Bilateral tonsillar metastasis of gastric adenocarcinoma, Head Neck 1992;14:55-7 https://doi.org/10.1002/hed.2880140112
  19. Owa AO, Gallimore AP, Ajulo SO, Cheesman AD. Metastatic adenocarcinoma of the ethmoids in a patient with previous gastric adenocarcinoma: a case report. J Laryngol Otol 1995; 8:759-61
  20. Spinelli GP, Caprio G, Tornao F, Barberi S, Miele E, Boghi F, et al. Metastatic infiltration of adenocarcinoma of the rectum in hard palate: Report of a case and a review of the literature. Oral Oncology Extra 2006:42:206-9
  21. Draizin D, Matucci K, Royhfeld S. Bilateral metastatic tonsillar disease due to renal cell carcinoma. Ear Nose Throat J 1978;57:14-8