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新型18F-FES PET/CT无创功能性诊断乳腺癌迟发性肺转移致霍纳综合征一例

Novel 18F-FES PET/CT in Non-invasive Functional Diagnosis of Delayed Lung Metastasis Presented with Horner Syndrome in a Metastatic Breast Cancer Patient

    摘要
  • 摘要: 激素受体阳性、人表皮生长因子受体2型阴性(HR+/HER2-)乳腺癌是最常见的乳腺癌分子亚型，可表现为术后10~15年以上的迟发性复发，且其肺转移病灶需与原发性肺癌相鉴别。本文报道1例HR+/HER2-乳腺癌术后16年迟发性肺转移致霍纳综合征患者，采用18F-FDG PET/CT难以判断肿瘤来源，穿刺活检风险高，经北京协和医院新型18F-FES PET/CT无创功能性诊断为乳腺癌肺上叶雌激素受体(estrogen receptor, ER)阳性转移，给予CDK4/6抑制剂+芳香化酶抑制剂内分泌解救治疗后获得缓解。本文总结该患者的临床表现及诊治经过，为新型18F-FES PET/CT评估乳腺癌患者转移灶的ER表达情况及指导后续个体化诊疗提供借鉴。

     

    Abstract: Hormonal receptor positive human epidermal receptor 2 negative (HR+/HER2-) is the commonest molecular subtype of breast cancer (BC). Patients with HR+/HER2- BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively. We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery. FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky. Novel 18F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive (ER+) pulmonary metastasis of BC, and the patient experienced partial response (PR) after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy. This article reviews the diagnosis and treatment process of this case, to provide guidance for non-invasive global evaluation of ER status among metastatic HR+/HER2- BC patients with 18F-FES PET/CT.

     

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