INCIDENTAL DETECTION OF PREVIOUSLY UNKNOWN BREAST CANCER ON Tc-99m MIBI SCINTIGRAPHY
INCIDENTAL DETECTION OF PREVIOUSLY UNKNOWN BREAST CANCER ON Tc-99m MIBI SCINTIGRAPHY
Aims: Tc-99m methoxyisobutylisonitrile scintigraphy is a diagnostic method commonly used for cardiac perfusion imaging. It is also used for parathyroid, lung, breast, thyroid, brain, melanoma, lymphoma, bone, and soft tissue primary and secondary tumors imaging. Our case aims to report a breast cancer incidentally revealed by Tc-99m methoxyisobutylisonitrile scintigraphy. Case Report: A 49-year-old female patient was admitted to the cardiology depart- ment with atypical angina. Tc-99m methoxyisobutylisonitrile scintigraphy showed myocardial perfusion was within normal limits but a focal uptake was detected in the lateral superior quadrant of the left breast. Ultrasonography detected a lesion with irregular borders in the outer quadrant of the left breast and a lymph node with increased thickness of the cortex in the left axilla. Magnetic resonance imaging showed a mass with a spiculated contour in the outer quadrant of the left breast and lymph nodes with increased cortex thickness in both axillae. By the histopathologic examination, the specimen was diag- nosed with invasive ductal carcinoma. Conclusion: Although Tc-99m methoxyisobutylisonitrile scintigraphy is mainly used for myocardial perfusion imag- ing, the entire image area should be examined in detail and further investigation should be done for incidental focal lesions that were previously undetected.
___
- 1. Palestro CJ, Tomas MB, Tronco GG. Radionuclide imaging of the parathyroid glands. Sem Nucl Med 2005;6(1):266-76.
- 2. Muzaffar R, Raslan O, Ahmed F et al. Incidental findings on myocardial perfusion SPECT images. J Nucl Med Technol 2017;45:175-80.
- 3. Fathala A. Myocardial perfusion scintigraphy: Techniques, interpretation, indica- tions and reporting. Ann Saudi Med 2011;31(6):625-34.
- 4. Bauer JL, Toluie S, Thompson LDR. Metastases to the parathyroid glands: A comprehensive literature review of 127 reported cases. Head Neck Pathol 2018;12(4):534-41.
- 5. Yoon HJ, Kim Y, Lee JE et al. Background 99mTc-methoxyisobutylisonitrile up- take of breast-specific gamma imaging in relation to background parenchymal enhancement in magnetic resonance imaging. Eur Radiol 2015;25:32-40.
- 6. Aktolun C, Bayhan H, Kir M. Clinical experience with Tc-99m MIBI imaging in patients with malignant tumors preliminary results and comparison with TI-201. Clin Nucl Med 1992;17(3):171-6.
- 7. Khalkhali I, Villanueva-Meyer J, Edell SL et al. Diagnostic accuracy of 99mTc-ses- tamibi breast imaging: Multicenter trial results. J Nucl Med 2000;41:1973-9.
- 8. Mathieu I, Mazy S, Willemart B et al. Inconclusive triple diagnosis in breast cancer
imaging: Is there a place or scintimammography? J Nucl Med 2005;46:1574-81.
- 9. Sadeghi R, Zakavi SR, Forghani MN et al. The efficacy of Tc-99m sestamibi for sentinel node mapping in breast carcinomas: A comparison with Tc-99m anti-
mony sulphide colloid. Nucl Med Rev Cent East Eur 2010;13:1-4.
- 10. Şeker D, Şeker G, Öztürk E et al. An incidentally detected breast cancer on Tc-99m MIBI cardiac scintigraphy. J Breast Cancer 2012;15(2):252-4.
- 11. Homma T, Manabe O, Ichinokawa K et al. Breast cancer detected as an incidental finding on 99mTc-MIBI scintigraphy. Acta Radiologica Open 2017;6(7):1-3.