Poor FDG Avidity in a Case of Metastatic Pulmonary Choriocarcinoma

Su, Hsuan-Ming; Hu, Chin-Yuan; Wu, Chia-Shang; Du, Wei-Ning; Tsay, Daw-Guey; Peng, Nan‐Jing

doi:10.1097/rlu.0b013e31821a289e

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…Breast choriocarcinoma detected by F-18 FDG PET/CT has not been reported. Previously, although several reports has described FDG accumulation in lung metastasis from choriocarcinomas [11]. In contrast, a few cases have shown low FDG accumulation in choriocarcinoma lesions [12].…”

Section: Discussionmentioning

confidence: 99%

Breast Carcinoma with Choriocarcinomatous Features: A Case Report

et al. 2013

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Nongestational choriocarcinoma differentiation is extremely rare in breast neoplasms. It is characterized by tumor cells similar to chorionic trophoblastic cells, which react with human placental lactogen and human chorionic gonadotropin (hCG). A 56-year-old woman presented with a palpable right breast mass without past history of trophoblastic tumors. An F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan revealed one focus with low accumulation of FDG in the right breast (maximum standardized uptake value, 1.98). The patient underwent a right mastectomy and biopsy of sentinel nodes. Microscopically, the tumor was a typical invasive ductal carcinoma with multiple foci of choriocarcinoma features. Immunohistochemistry showed that the tumor cells resembling choriocarcinoma were positive for hCG antibody, but negative for HER2/neu, estrogen receptor, and progesterone receptor. A pathologic diagnosis of breast carcinoma with choriocarcinomatous features was made. To our knowledge, this is the first report of invasive carcinoma with choriocarcinomatous features and an unusual finding of low accumulation in an F-18 FDG PET/CT scan in Korea.

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Section: Discussionmentioning

confidence: 99%

Breast Carcinoma with Choriocarcinomatous Features: A Case Report

et al. 2013

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A case of pulmonary choriocarcinoma metastasis with unusual FDG-PET and CT findings: correlation with pathology

et al. 2012

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A 26-year-old female who had had a hydatidiform mole at 20 years of age showed high levels of serum human chorionic gonadotropin. Because pelvic ultrasound did not show any gestational sac in her uterus, she was suspected to have had an extrauterine pregnancy and a spontaneous abortion. About 6 months later, a pulmonary nodule in the patient's right upper lung field was found on a routine chest X-ray film. Contrast- enhanced CT scans revealed a solitary lobulated nodule 2.0 × 1.3 × 3.0 cm in diameter in the S2 segment of the right lung. CT suggested a vessel malformation. Positron emission tomography using 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG-PET) was performed and showed weak FDG accumulation (SUVmax = 2.0) in the nodule, which did not positively indicate malignancy. Because a follow-up CT showed a rapid increase in the size of the nodule, partial resection of S2 segment in the right upper lobe was performed. The histopathological diagnosis was a metastasis from choriocarcinoma. The tumor consisted largely of necrosis and hemorrhage, and it was considered to be a major cause of the unusual FDG-PET and CT findings.

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Potential Pitfall of FDG PET/CT in Assessing Residual Masses Postchemotherapy

Wong²,

Seet³

et al. 2013

Clinical Nuclear Medicine

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A 22-year-old man with primary mediastinal choriocarcinoma and bilateral lung metastases underwent an FDG PET/CT scan after completing chemotherapy. Serum beta-human chorionic gonadotropin had normalized. PET/CT showed increased FDG uptake in the anterior mediastinal and lung lesions, suspicious for residual disease. After resection of the mediastinal and lung lesions, histopathology revealed necrosis and fibrohistiocytic reaction with no viable tumor. There was discordance between beta-human chorionic gonadotropin (negative) and FDG PET/CT (positive) findings, with PET/CT findings being false positive. Awareness of this potential pitfall of FDG PET/CT is important, and caution should be exercised when using FDG PET/CT to assess residual masses after chemotherapy.

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Poor FDG Avidity in a Case of Metastatic Pulmonary Choriocarcinoma

Cited by 4 publications

References 8 publications

Breast Carcinoma with Choriocarcinomatous Features: A Case Report

Breast Carcinoma with Choriocarcinomatous Features: A Case Report

A case of pulmonary choriocarcinoma metastasis with unusual FDG-PET and CT findings: correlation with pathology

Potential Pitfall of FDG PET/CT in Assessing Residual Masses Postchemotherapy

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