Contribution of 18-fluorodeoxyglucose positron emission tomography (FDG PET) imaging in the detection of underlying carcinoma in a woman with nonspecific mastitis

  • Oguz Hancerliogulları Faculty of Medicine, Department of General Surgery, Etlik-Ankara, Turkey
  • Semra Ince Faculty of Medicine, Gulhane Military Medical Academy, Departments of Nuclear Medicine, Etlik-Ankara, Turkey
  • Rahman Senocak Faculty of Medicine, Department of General Surgery, Etlik-Ankara, Turkey
  • Seyfettin Ilgan Faculty of Medicine, Gulhane Military Medical Academy, Departments of Nuclear Medicine, Etlik-Ankara, Turkey
  • Nuri Arslan Faculty of Medicine, Gulhane Military Medical Academy, Departments of Nuclear Medicine, Etlik-Ankara, Turkey
Keywords: breast diseases;, breast neoplasms;, mastitis;, diagnosis, differential;, positron-emission tomography.

Abstract


Introduction. Differentiation between a malignancy and in­flammatory process is still a diagnostic challenge. Mammog­raphy (MG) and ultrasonography (US) have low sensitivity and specificity in dense breasts in order to detect malig­nancy. On the other hand, malignant mass lesions can also be masked on magnetic resonance imaging (MRI) by diffuse inflammatory process. 18-fluorodeoxyglucose positron emission tomography (FDG PET) imaging can be a prom­ising alternative imaging method in the evaluation of suspi­cious breast masses, especially in patients with accompany­ing inflammatory breast diseases. Case report. We report an atypical case of a patient suspected for malignancy in right breast on physical examination and radiologic findings in favor of mastitis. Neither MG nor US revealed any mass lesion consistent with malignancy. Moreover, MRI findings were primarily considered as infectious or granulomatous mastitis. However, FDG PET determined the accurate bor­ders of tumor and dissemination of breast cancer with supe­riority to other conventional radiological methods. Conclu­sion. This case report emphasizes the contribution of FDG PET imaging to other conventional radiological methods with regard to primary tumor diagnosis, determination of the biopsy site, and also staging the disease especially in pa­tients with accompanying inflammatory breast disease.

Introduction. Differentiation between a malignancy and in­flammatory process is still a diagnostic challenge. Mammog­raphy (MG) and ultrasonography (US) have low sensitivity and specificity in dense breasts in order to detect malig­nancy. On the other hand, malignant mass lesions can also be masked on magnetic resonance imaging (MRI) by diffuse inflammatory process. 18-fluorodeoxyglucose positron emission tomography (FDG PET) imaging can be a prom­ising alternative imaging method in the evaluation of suspi­cious breast masses, especially in patients with accompany­ing inflammatory breast diseases. Case report. We report an atypical case of a patient suspected for malignancy in right breast on physical examination and radiologic findings in favor of mastitis. Neither MG nor US revealed any mass lesion consistent with malignancy. Moreover, MRI findings were primarily considered as infectious or granulomatous mastitis. However, FDG PET determined the accurate bor­ders of tumor and dissemination of breast cancer with supe­riority to other conventional radiological methods. Conclu­sion. This case report emphasizes the contribution of FDG PET imaging to other conventional radiological methods with regard to primary tumor diagnosis, determination of the biopsy site, and also staging the disease especially in pa­tients with accompanying inflammatory breast disease.

References

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Published
2021/01/08
Section
Case report