Taşlı yüzük hücre diferansiye meme kanserinde F18-florodeoksiglikoz positron emisyon tomografi/bilgisayarlı tomografi bulguları: Tek merkez deneyimi

Amaç: Tüm meme kanserlerinin %1’inden daha azını oluşturan taşlı yüzük hücre diferansiye meme kanseri vakalarının nadir görülmesi nedeniyle, görüntüleme özellikleri hakkında sınırlı bilgi bulunmaktadır. Bu çalışmanın amacı, taşlı yüzük hücreli diferansiye meme kanserinin evrelemesinde 18F-FDG PET/BT’nin yararlılığını değerlendirmektir. Yöntemler: 2014 ile 2023 yılları arasında kurumumuzda 18F-FDG PET/BT yapılan, histopatolojik olarak teyit edilmiş taşlı yüzük hücreli diferansiye meme kanseri tanısı alan 14 hasta üzerinde retrospektif bir analiz gerçekleştirdik. Görüntüleme bulguları, maksimum standartlaştırılmış uptake değeri (SUVmax), lezyon boyutu ve bölgesel veya uzak metastaz varlığı istatistiksel olarak incelendi. Bulgular: Taşlı yüzük hücreli diferansiye primer tümörlerin histolojik alt tipleri, 9 invaziv lobüler ve 5 invaziv duktal karsinomdu. Primer tümör lezyonlarında duktal alt tipin (ortalama SUVmax: 18.8±9.8; aralık: 2.6–28.9) lobüler alt tip (ortalama SUVmax: 2.6±1.3; aralık: 1.5–5.1) ile karşılaştırıldığında daha yoğun 18F-FDG tutulumu gösterdiği saptandı (p=0.007, Z=2.600). Çalışmaya dahil edilen hastalar arasında, vakaların %64’ünde (n=9) aksiller lenf nodu metastazı bulunurken, duktal karsinom olarak sınıflandırılan beş vakada lenf nodu metastazı saptandı. Ayrıca, hastaların %21’inde (n:3) uzak organ metastazı tespit edildi; bunların ikisi duktal karsinom ve biri lobüler karsinom idi. Sonuç: Taşlı yüzük hücreli tümörlerin 18F-FDG’ye düşük affinitesi olduğu genel kabul görmesine rağmen, çalışmamız duktal karsinomlu olgularda yüksek 18F-FDG tutulumu olabileceği gözlemlemiştir. Lobüler karsinomlu olgularda ise 18F-FDG tutulumunun düşük olması nedeniyle, diğer PET radyofarmasötikleri ile görüntüleme seçenekleri düşünülebilir.

Anahtar Kelimeler:

Fluorodeoksiglukoz F18, meme kanseri, pozitron emisyon tomografi, bilgisayarlı tomografi, taşlı yüzük hücreli karsinom

18F-fluorodeoxyglucose positron emission tomography/computed tomography findings of breast cancer with signet ring cell differentiation: A single-center experience

Aim: Due to the low incidence of breast cancer with signet ring cell (SRC) differentiation, which constitutes less than 1% of all breast cancers, little is known about its imaging features. The aim of this study was to evaluate the utility of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in staging breast cancer with SRC differentiation. Methods: We conducted a retrospective analysis of 14 patients with histologically confirmed breast cancer with SRC differentiation who underwent 18F-FDG PET/CT at our institution between 2014 and 2023. The imaging findings were analyzed in terms of maximum standardized uptake value (SUVmax), lesion size, and the presence of regional or distant metastases were statistically evaluated. Results: The histological subtypes of SRC differentiated primary tumors were 9 invasive lobular, and 5 invasive ductal carcinoma. More intense 18F-FDG uptake was observed in primary tumoral lesions of the ductal subtype (mean SUVmax: 18.8±9.8; range: 2.6–28.9) compared to the lobular subtype (mean SUVmax: 2.6±1.3; range: 1.5–5.1) (p=0.007, Z=2.600). Among the patients included in the study, axillary lymph node metastasis was present in 64% (n=9) of the cases, with lymph node metastasis identified in five cases classified as ductal carcinoma. Additionally, distant organ metastasis was identified in 21% (n=3) of patients, comprising two patients with ductal carcinoma and one with lobular carcinoma. Conclusion: Despite the general consensus that signet-ring cell tumors have a low affinity for 18F-FDG, our study has observed the possibility of high 18F-FDG uptake in cases of ductal carcinoma. However, in cases of lobular carcinoma, where 18F-FDG uptake tends to be low, considering alternative PET radiopharmaceuticals for imaging could be a viable option.

Keywords:

Breast cancer, fluorodeoxyglucose F18, positron emission tomography, computed tomography, signet ring cell carcinoma,

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