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LETTER TO EDITOR
Year : 2015  |  Volume : 30  |  Issue : 4  |  Page : 369  

Splenic metastasis of breast cancer: A rare metastatic site depicted on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography


Department of Nuclear Medicine, School of Medicine, Bulent Ecevit University, Zonguldak, Turkey

Date of Web Publication1-Sep-2015

Correspondence Address:
Tarik Elri
Department of Nuclear Medicine, School of Medicine, Bulent Ecevit University, Esenkoy/Kozlu, 67600 Zonguldak
Turkey
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Source of Support: Nil., Conflict of Interest: There are no conflicts of interest.


DOI: 10.4103/0972-3919.159697

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How to cite this article:
Elri T, Aras M, Salihoglu YS, Cabuk M. Splenic metastasis of breast cancer: A rare metastatic site depicted on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med 2015;30:369

How to cite this URL:
Elri T, Aras M, Salihoglu YS, Cabuk M. Splenic metastasis of breast cancer: A rare metastatic site depicted on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med [serial online] 2015 [cited 2019 Dec 7];30:369. Available from: http://www.ijnm.in/text.asp?2015/30/4/369/159697



Sir,

Metastatic involvement of the spleen in solid tumors is quite a rare entity and usually accompanied by disseminated visceral metastases that indicating terminal stage.[1],[2],[3] A large-scale autopsy based retrospective study showed that, the prevalence of splenic metastasis in patients with the malignant solid tumor was 3.0%, and breast cancer was a primary tumor in only 12.3% of all these spleen metastases.[1] Herein, we presented a rare case of splenic metastasis of breast cancer detected by fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT).

A 71-year-old female presented with a palpable breast mass was subjected to Tru-cut needle (14GX15cm, Gallini MD, Istanbul, Turkey) biopsy. Based on histologic findings a diagnosis of infiltrating ductal carcinoma was made. Then she was referred for a whole body PET scan for initial staging. F-18 FDG PET/CT showed high FDG uptake within the primary lesion, which was seen in the lower inner quadrant of right breast. Multiple FDG avid metastases of right axillary lymph nodes, right lung, liver, and bones were also seen. In addition to these, a 5 cm × 4 cm hypodense mass lesion with intense peripheral FDG uptake in the spleen was detected [Figure 1]. Though lack of histological examination, this finding considered to be a metastasis of primary tumor, due to multiple metastases, which were seen in other sites of the whole body.
Figure 1: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography showed intense hypermetabolic primary lesion in the right breast (arrows in a: Positron emission tomography, computed tomography, and fusion positron emission tomography/computed tomography images). Multiple moderate-intense hypermetabolic metastatic lesions were also seen in the right axilla, right lung, liver, and bones (b: Maximum intensity projection image). In addition to these, intense hypermetabolic hypodense lesion with 5 cm × 4 cm in diameter in the spleen was detected (arrows in c: Positron emission tomography, computed tomography, and fusion positron emission tomography/computed tomography images)

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Regional and distant lymph nodes, bones, lungs, liver, and brain are the most common sites of metastatic spread in breast cancer. Whereas, splenic metastasis from breast cancer is quite rare, and only a few cases have been reported.[3] Though histology from the splenic site is not available, but there is little doubt that it is not a metastatic involvement, given the widespread disease on whole body FDG PET/CT scan and hypodense lesion on CT images.[3],[4] To our knowledge, this is the first report of this unusual behavior of breast cancer that showed on F-18 FDG PET/CT.

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Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Schön CA, Görg C, Ramaswamy A, Barth PJ. Splenic metastases in a large unselected autopsy series. Pathol Res Pract 2006;202:351-6.  Back to cited text no. 1
    
2.
Agrawal A, Jatale P, Purandare N, Shah S, Rangarajan V. Rare splenic metastasis of renal cell carcinoma detected on (99m) Tc-MDP bone scan. Indian J Nucl Med 2014;29:60-1.  Back to cited text no. 2
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3.
Sufficool K, Wang J, Doherty S. Isolated splenic metastasis from carcinoma of the breast: A case report. Diagn Cytopathol 2013;41:914-6.  Back to cited text no. 3
    
4.
Barreca M, Angelini D, Gallo A, Puntillo F, Amodio PM, Fernandes E. Single asymptomatic splenic metastasis of breast carcinoma: Report of a clinical case. G Chir 2001;22:227-8.  Back to cited text no. 4
    


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