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Paradoxal metabolic flare detected by 18F-fluorodeoxyglucose positron emission tomography in a patient with metastatic breast cancer treated with aromatase inhibitor and biphosphonate.

D'Amico A, Kowalska T - Indian J Nucl Med (2014)

Bottom Line: We describe a case of a patient with invasive ductal breast cancer with bone metastases at bone scintigraphy and FDG PET scan and with expression of estrogen receptors.Owing to progression observed in a bone scan, Tamoxifen was substituted with aromatase inhibitors.Successive bone scan examinations showed stabilization with a marked clinical improvement.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic PET, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.

ABSTRACT
Patients with estrogen-receptor-positive advanced breast cancer are treated with endocrine therapy. The majority of breast cancer localizations show 18F-fluorodeoxyglucose (FDG) uptake at positron emission tomography (PET) examination. In these patients, the metabolic flare after therapy is common and was proposed as an index of therapy efficacy. Nevertheless, prolonged persistence of flare can lead to misinterpretation. We describe a case of a patient with invasive ductal breast cancer with bone metastases at bone scintigraphy and FDG PET scan and with expression of estrogen receptors. Initially, the patient underwent endocrine therapy in addition to a biphosfonate. Owing to progression observed in a bone scan, Tamoxifen was substituted with aromatase inhibitors. Successive bone scan examinations showed stabilization with a marked clinical improvement. A second FDG PET was performed 28 months after the first examination and showed a metabolic flare phenomenon with concomitant partial calcification of osteolitic lesions. This is an unusual case of prolonged metabolic flare.

No MeSH data available.


Related in: MedlinePlus

First 18F-fluorodeoxyglucose positron emission tomography performed on 1st October 2010: Maximum intensity projection projection with some pathological uptakes in the sternum, ribs, both humeri and right femur
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Figure 2: First 18F-fluorodeoxyglucose positron emission tomography performed on 1st October 2010: Maximum intensity projection projection with some pathological uptakes in the sternum, ribs, both humeri and right femur

Mentions: The first FDG PET scan was ruled out in Gliwice branch of our institution on October 1, 2010 in order to exclude metastatic spread to soft-tissues. It was performed with the use of a Philips Gemini GXL device, 60 min after an injection of 333 MBq of radiotracer. Numerous skeletal lesions were detected, with no metastases outside bones [Figure 2a].


Paradoxal metabolic flare detected by 18F-fluorodeoxyglucose positron emission tomography in a patient with metastatic breast cancer treated with aromatase inhibitor and biphosphonate.

D'Amico A, Kowalska T - Indian J Nucl Med (2014)

First 18F-fluorodeoxyglucose positron emission tomography performed on 1st October 2010: Maximum intensity projection projection with some pathological uptakes in the sternum, ribs, both humeri and right femur
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928749&req=5

Figure 2: First 18F-fluorodeoxyglucose positron emission tomography performed on 1st October 2010: Maximum intensity projection projection with some pathological uptakes in the sternum, ribs, both humeri and right femur
Mentions: The first FDG PET scan was ruled out in Gliwice branch of our institution on October 1, 2010 in order to exclude metastatic spread to soft-tissues. It was performed with the use of a Philips Gemini GXL device, 60 min after an injection of 333 MBq of radiotracer. Numerous skeletal lesions were detected, with no metastases outside bones [Figure 2a].

Bottom Line: We describe a case of a patient with invasive ductal breast cancer with bone metastases at bone scintigraphy and FDG PET scan and with expression of estrogen receptors.Owing to progression observed in a bone scan, Tamoxifen was substituted with aromatase inhibitors.Successive bone scan examinations showed stabilization with a marked clinical improvement.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic PET, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.

ABSTRACT
Patients with estrogen-receptor-positive advanced breast cancer are treated with endocrine therapy. The majority of breast cancer localizations show 18F-fluorodeoxyglucose (FDG) uptake at positron emission tomography (PET) examination. In these patients, the metabolic flare after therapy is common and was proposed as an index of therapy efficacy. Nevertheless, prolonged persistence of flare can lead to misinterpretation. We describe a case of a patient with invasive ductal breast cancer with bone metastases at bone scintigraphy and FDG PET scan and with expression of estrogen receptors. Initially, the patient underwent endocrine therapy in addition to a biphosfonate. Owing to progression observed in a bone scan, Tamoxifen was substituted with aromatase inhibitors. Successive bone scan examinations showed stabilization with a marked clinical improvement. A second FDG PET was performed 28 months after the first examination and showed a metabolic flare phenomenon with concomitant partial calcification of osteolitic lesions. This is an unusual case of prolonged metabolic flare.

No MeSH data available.


Related in: MedlinePlus