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題名 | The Solitary Scalp Metastasis from Pulmonary Squamous Cell Carcinoma Seen on FDG PET/CT=氟化去氧葡萄糖正子斷層造影偵測頭皮轉移性肺鱗狀上皮細胞癌 |
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作者姓名(中文) | 蔡季蓉; 高鴻偉; 簡志峰; 程紹智; 鄭澄意; 諶鴻遠; 黃文盛; | 書刊名 | 核子醫學雜誌 |
卷期 | 23:2 2010.06[民99.06] |
頁次 | 頁99-105 |
分類號 | 416.14 |
關鍵詞 | 頭皮轉移; 氟化去氧葡萄糖正子斷層造影; 肺部鱗狀上皮細胞癌; Scalp metastasis; Pulmonary squamous cell carcinoma; FDG PET/CT; |
語文 | 英文(English) |
中文摘要 | 從肺癌轉移至皮膚之單一病灶是一極不尋常的發現,特別是發生在頭皮。我們報告一位有著吸煙將近30年歷史的57歲男性,表現出已有一個月聲音沙啞、喝東西容易嗆到的症狀。他先在耳鼻喉科求診,發現左側聲帶麻痺和右上頭皮腫塊等症狀幾乎同時發生。之後常規性的胸部X光片顯示左下肺在心臟後面的位置有一結節亮點,此結節之病理組織最後爲肺部鱗狀上皮細胞癌。而頭皮的腫塊經向切片後報告爲良性纖維化表現。爲進行肺癌之分期,病人接受了FDG PET/CT,卻意外發現在頭皮有一異常之高度葡萄糖代謝病灶,因疑似爲惡性,於是參考FDG吸收的區域後,病人再次接受頭皮切片檢查,確認爲源自於肺癌之轉移性鱗狀上皮癌。在最初症狀發生後,病人僅存活了九個月。在此我們提出此一罕見病例,並強調氟化去氧葡萄糖正子攝影有助於病灶切片位置之選擇。 |
英文摘要 | The solitary skin metastasis from lung cancers is an unusual event, particularly in the scalp. We report a case of 57-year-old male with a history of heavy smoking for nearly 30 years who has experienced hoarseness and easily choking while drinking for about 1 month. Simultaneously developed symptoms of left vocal cord paralysis and a scalp lesion over the right upper vertex were initially noted by an otolaryngologist. A routine chest X-ray demonstrated a nodular density at retrocardiac region of left lower lung that turned out to be a squamous cell carcinoma (SCC) histologically. However, a benign fibrotic change was reported from biopsy of the scalp lesion. An FDG PET/CT was performed for staging of the lung cancer and incidentally found an unusually high uptake of FDG in the scalp lesion. Under tentative diagnosis of malignancy, he received a repeated biopsy of the scalp lesion in reference to the FDG uptake site and confirmed as a metastatic SCC consistent with the primary lung malignancy. The patient survived 9 months after onset of symptoms. We present this rare case here and illustrate clinical usefulness of FDG uptake in allocating sites of biopsy. |
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