病例报告:创伤后脾肿大和 PSMA-PET 的潜在隐患。

Marina Nearchou, Elizabeth Georgiou, Alexis Vrachimis, Konstantinos Ferentinos, Iosif Strouthos
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引用次数: 0

摘要

背景:18F-前列腺特异性膜抗原(PSMA)PET正迅速成为前列腺癌的金标准,既可用于中/高危患者的分期,也可用于生化检查失败患者的再分期。据我们所知,我们首次报告了一例可能被误诊为腹膜扩散的病例:一名 67 岁的高危前列腺癌患者接受了 18F-PSMA-1007 PET/CT (PSMA-PET/CT)分期检查。PSMA-PET/CT显示,经组织学证实的前列腺恶性肿瘤位于左侧外周区。意想不到的是,患者腹腔内还发现了多个高 PSMA 表达的肿瘤。基于明显的解剖学脾肿大和儿童时期的外伤性脾脏破裂病史,该患者被怀疑患有外伤后脾肿大。为了进行进一步的非侵入性评估,患者接受了 C-99 硫胶体闪烁扫描和 SPECT 检查,结果证实存在多个功能性异位脾组织。据我们所知,这是首例利用 18F-PSMA-1007-PET/CT 和 99mTc 硫胶体 SPECT 检测腹腔内脾脏病变的病例,凸显了核医学在此类琐碎病例中的巨大潜力。
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Case Report: Post-traumatic splenosis and potential pitfall for PSMA-PET.

Background: 18F-prostate specific membrane antigen (PSMA) PET is fast becoming the gold-standard in prostate cancer, both in staging of intermediate-/high-risk patients and in re-staging patients with biochemical failure. Several pitfalls of 18F-PSMA PET have been reported, and we report, to our best of knowledge, for the first time, a case which could have been falsely diagnosed as peritoneal spread.

Case presentation: A 67-year-old patient with high-risk prostate cancer underwent staging with 18F-PSMA-1007 PET/CT (PSMA-PET/CT). PSMA-PET/CT revealed a histologically confirmed prostatic malignancy in the peripheral left zone. Unexpectedly, additional multiple highly PSMA-expressing intraabdominal formations were discovered. Based on apparent anatomic asplenia and a history of traumatic splenic rapture during childhood, a suspicion of post-traumatic splenosis was raised. For further non-invasive evaluation, a C-99 sulphur colloid scintigraphy with SPECT was conducted, confirming the presence of multiple functional ectopic splenic tissues. This is, to our best of knowledge, the first case utilising 18F-PSMA-1007-PET/CT and 99mTc-sulphur colloid SPECT to detect intraabdominal splenosis, highlighting the high potential of nuclear medicine in such trivial cases.

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