World Journal of Nuclear Medicine最新文献

Patients of head and neck squamous cell carcinoma (HNSCC) experience increased risk of developing second primary cancer (SPC) necessitating active surveillance during their disease course. SPCs are associated with poor prognosis and are the leading cause of long-term morbidity and mortality impacting survival of patients with HNSCC. Small cell neuroendocrine carcinoma (SmNEC) is a rare but aggressive neoplasm with poor prognosis and high risk of local recurrence and distant metastasis. We report an exceedingly rare case of nasopharyngeal carcinoma (NPC) presenting as a recurrence in the form of metachronous second primary to primary SmNEC 9 years after chemotherapy. The dual tracer positron emission tomography and computed tomography (PET/CT) imaging approach ([ ⁶⁸ Ga]Ga-DOTATATE-PET/CT with ¹⁸ F-FDG-PET/CT) was explored in such metachronous NPCs, and the findings are illustrated with its potential for theranostic applications. NPC is a rare malignancy with significant geographical variations in incidence rates. Somatostatin receptor 2 (SSTR2) expression in NPC is well documented and can serve as a potential theragnostic marker in advanced NPC where the successful outcome is minimal with currently available treatment modalities.

Purpose  The aim of our study was to evaluate the compatibility of lacrimal syringe test with dacryoscintigraphy (DSG) in the postoperative evaluation of external dacryocystorhinostomy (Ext-DCR) surgery. Material and Methods  Thirty eyes of 30 patients suffering from unilateral epiphora with discharge and showing complete obstruction on lacrimal irrigation test were included in the study. Patients with dysfunctional lacrimal pump function, revision surgery, partial obstruction, and ocular surface diseases were not included in the study. Verification of the nasolacrimal duct obstruction (NLDO) was achieved with dye disappearance test, Jones test 1 (JT 1), and JT 2. According to the type of obstruction seen on DSG, patients were classified into two groups: presac and postsac obstruction. Patients with complete obstruction detected in the lacrimal syringing and dynamic scintigraphy underwent Ext-DCR, and the results were evaluated. Results  Thirty patients, mean age 58.93 ± 12.11 years, all with unilateral NLDO were included in the study. All had grade 5 Munk score epiphora and discharge. The mean duration of obstruction was 24.57 ± 10.65 months. In the lacrimal irrigation test, all patients had complete obstruction in one eye, while the other eye was normal. According to preoperative DSG results, there were 20 (66.7%) patients with presac delay and 10 (33.3%) patients with postsac delay. All patients underwent Ext-DCR with silicone tube intubation and were followed for 1 year. Although there was symptomatic improvement in all patients and the lacrimal syringing test was patent, no change was seen in scintigraphy. Conclusion  Although DSG is a sensitive nuclear medicine method, it is not useful for predicting the functional success of the Ext-DSR.

Ewing's sarcoma (ES) is a mesenchymal origin malignant neoplasm that affects children and adolescents. It is the second most common type of bone sarcoma and accounts for approximately 1.5% of all childhood cancers with an annual incidence of 1 to 3 cases per million children under 16 years of age. In this article, we present the case of a 16-year-old adolescent girl. Lung metastasis at the initial diagnosis of ES is relatively uncommon but carries significant prognostic implications. Lung metastases in ES can vary significantly in size, ranging from small nodules (just a few millimeters in size) to the largest reported case being 15 cm. The size of the metastases impacts the choice of therapeutic strategies and the prognosis. Approximately 30% of patients with ES experience a relapse, with the lungs being a common site for metastatic disease. Relapsed lung metastasis on follow-up is a critical concern in the long-term management of ES. We describe a relapsed case of ES in a 16-year-old adolescent girl who presented with a solitary large metastatic right lung mass, with the longest dimension of 16 cm on craniocaudal measurement. The primary site of the tumor was the left distal femur, for which the patient received six cycles of neoadjuvant chemotherapy, followed by en bloc tumor excision and rotationplasty of the left distal femur, after which the patient received seven cycles of adjuvant chemotherapy. Subsequent 5 years of regular follow-up was asymptomatic. Later, the patient presented with back pain and cough, and was diagnosed with a solitary large right lung mass. Computed tomography (CT) guided biopsy of the right lung mass revealed a metastatic ES, for which she underwent chemoradiotherapy. This case highlights the large size of solitary lung metastases in relapsed ES.

A unique case of papillary carcinoma of the thyroid with an extensive tumor thrombus extending into the right ventricle is presented. The patient was a known case of solid variant of papillary carcinoma of thyroid, post three cycles of radioiodine therapy, had reported for a diagnostic ¹³¹ I-NaI scintigraphy as a part of the workup for planning the next ¹³¹ I therapy. Clinically, the patient was asymptomatic. ¹³¹ I-NaI scintigraphy showed an arcuate pattern concentration of tracer in the upper mediastinum, which descended up to the lower mediastinum. A ¹³¹ I-NaI single photon emission computed tomography/computed tomography (SPECT/CT) showed a tracer avid tumor with an extensive tumor thrombus extending from the left brachiocephalic vein to the right ventricle. ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸ F-FDG-PET/CT) and magnetic resonance imaging (MRI) demonstrated similar findings. The patient was decided to be managed with tyrosine kinase inhibitors as surgical intervention was not deemed possible due to the involvement of major vessels and the high risk of bleeding.