Opere penis kanserli bir olguda F18-FDG PETI BT ile saptanan spinal sinir invazyonu

The spial nerve invasıon detected with 18F- FDG PET/CT in an operated patient with penile cancer

Zuhal KANDEMİR,Elis ÖZDEMİR,Nilüfer YILDIRIM POYRAZ,MutIay KESKİN,ŞEYDA TÜRKÖLMEZ,Hatice Filiz ERDİL ERYILMAZ

Abstract

Penile cancers compose less than 1% of all urogenital cancers. Spinal nerve invasion was not reported in the literature before. In this case report,our aim was to present the 18F- FDG PET/ CT images of patient who had surgery due to penile cancer. Spinal nerve invasion was detected in the PET/CT images and this is correlated with MRI. 57-year-old patient, after two years he had radical penectomy surgery, had an abdominopelvic CT scan in terms of control. Following the detection of soft tissue lesion in the right obturator region during abdominopelvic CT imaging, this patient was directed to our clinic for PET/CT scanning.ln the PET/CT images, in the right obturator region, high pathologic 18F- FDG uptake was observed in soft tissue lesion which was considered as metastasis. In addition, at the right S-2 foramen level, gradually increased FDG uptake was observed. In the MRI scan which was performed for correlation, in the right SZ nerve root, asymmetric contrast uptake was seen. Spinal nerve invasion is difficult to detect .As PET/CT has the advantage to scan whole body, perform anatomical and functional imaging at the same time, it detected the spinal nerve invasion.This finding was also verified with MRI.

Özet

Penis kanseri, ürogenital kanserlerin %1'inden azını oluşturmaktadır. Spinal sinir invazyonu ise literatürde daha önce bildirilmemiştir. Bu olgu sunumunda, opere penis karsinomlu hastada, F18-FDG PET/BT taramasında tespit edilen ve MRG ile korelasyon gösteren, spinal sinir invazyonunun görüntülerini sunmayı amaçladık. Radikal penektomi operasyonu geçirmiş 57 yaşındaki hastanın yapılan PET/BT taramasında; sağ obturator bölgede metastaz ile uyumlu yumuşak doku Iezyonunda ve sag sakral 2. foramen düzeyinde patolojik artmış FDG tutulumu izlendi. Korelasyon amaçlı yapılan MRG tetkikinde, sağ S2 sinir kökünde asimetrik kontrast tutulumu izlendi. Spinal sinir invazyonunu tespit edilmesi güçtür. PET/BT, tüm vücut tarama, anatomik ve fonksiyonel görüntülemenin birlikte yapılabilmesi avantajları ile bu olguda spinal sinir invazyonunu tespit etmiş olup tanı MRG ile de doğrulanmıştır.