Targeted Sacral Biopsy With Portable Gamma Camera and Intraoperative Gamma Probe
Sandra Rama Alonso1, Eva Campaña Díaz, Juan Francisco Blanco Blanco
1From the Department of Nuclear Medicine, University Hospital of Salamanca, Salamanca, Spain.
Clinical Nuclear Medicine
|August 16, 2024
Summary
This study details a case of a man with suspected metastasis. Radioguided biopsy confirmed epidermoid carcinoma metastasis in the sacrum, originating from a tonsil tumor.
Area of Science:
- Oncology
- Nuclear Medicine
- Pathology
Background:
- A 58-year-old male patient with a history of prostate carcinoma presented with dysphagia and trismus.
- Physical examination revealed a right tonsil tumor and ipsilateral laterocervical adenopathies.
Observation:
- Positron Emission Tomography/Computed Tomography (PET/CT) showed focal fluorodeoxyglucose (FDG) uptake in the tonsilar lesion (SUVmax 10.89).
- Increased glycemic metabolism was noted in the left sacral wing (SUVmax 10.90) on PET/CT, with corresponding tracer uptake on bone scan, despite no clear CT morphological lesion.
- Metastatic involvement was suspected based on imaging findings.
Findings:
- Radioguided biopsy of the sacral lesion was performed for etiological determination.
- Histological analysis of the metastasis confirmed epidermoid carcinoma.
Implications:
- This case highlights the utility of PET/CT and radioguided biopsy in diagnosing metastatic disease.
- Early detection and accurate diagnosis are crucial for effective cancer management.
- The findings underscore the importance of investigating unexpected metabolic activity in bone, even without clear morphological changes on CT.
