Ovarian Metastasis as Initial Presentation of Pancreatic Carcinoma on FDG PET/CT

The Isolated Humeral Metastasis as the Initial Presentation of Renal Cell Carcinoma Revealed by 18 F-FDG PET/CT

ABSTRACT

Renal cell carcinoma (RCC) with isolated humeral metastasis as the initial presentation is rare. We reported FDG PET/CT findings of isolated humeral metastasis from RCC in a 63-year-old man with right upper arm pain as the initial presentation. The bone scanning in an outside hospital showed that the focus with increased uptake of the right humerus was possibly malignant. FDG PET/CT showed that the right humeral mass had intense activity, and there was an additional FDG lesion in the lower pole of the right kidney. The mass of the right humerus was later confirmed as humeral metastasis from RCC by pathological examination.

The Humeral Metastasis as the Initial Presentation of Lung Adenocarcinoma Revealed by 18F-FDG PET/CT

ABSTRACT

Lung adenocarcinoma with humeral metastasis as the initial presentation is rare. We reported FDG PET/CT findings of solitary humeral metastasis from adenocarcinoma of the lung in a 57-year-old man with the right upper arm pain as the initial presentation. MRI showed bone destruction of the right humerus with a soft tissue mass, suggesting the possibility of malignancy. FDG PET/CT showed that the right humeral mass had strong activity, and there were additional FDG lesions in the right armpit, left apical lung, and left adrenal gland, which was later confirmed as humeral metastasis from lung adenocarcinoma by pathological examination.

Primary pancreatic cystadenocarcinoma with ovarian metastases in a 38-year-old female: case report

Pancreatic cystadenocarcinoma with ovarian metastases is rare and easily misdiagnosed as primary ovarian cancers. Here we report 38-year-old female manifested tumors in pancreas and ovary concurrently, which was difficult to distinguish the primary site. She was admitted to hospital because of abdominal distension and a palpable mass in the lower abdomen. Abdominal ultrasound showed a lesion in pancreas and two masses in bilateral ovaries. Computed tomography (CT) revealed the hypo-enhancing pancreatic mass and the large pelvic lesion simultaneously. The largest cross-sectional of the right mass was 12×15.1 cm and 15.4×18.3 cm for the left side, probably malignant lesions. In addition, the level of the serum CA19-9 and CA125 were higher than the normal level. Positron emission tomography CT (PET-CT) revealed there might be the cystadenocarcinoma in the pancreatic tail with multiple metastatic lesions implanted in the pelvic. After comprehensive examination, she received bilateral salpingo-oophorectomy and biopsy of the pancreatic tumor. The pathological finding revealed that it was pancreatic cystadenocarcinoma with ovarian metastases. Postoperatively, she received the chemotherapy and the follow-up continued for 26 months until she died. This case reminded doctors that pancreatic primaries should be paid attention when dealing with metastatic ovarian malignancies although it was rare. Choosing effective diagnostic method and timely surgical intervention are essential to improve prognosis.