Abstract
A 49-year-old premenopausal woman with a history of left modified radical mastectomy and axillary lymph node dissection for invasive lobular carcinoma three years ago, underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) due to gradually increasing CA15-9 and CEA levels during routine follow-up. Compared with previous 18F-FDG PET/CT images, the left ovary in the current images showed increased size and radiotracer uptake. Subsequently, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed, and histopathological evaluation confirmed unilateral metastasis in the left ovary due to primary breast cancer. Although rare, possible isolated ovarian metastasis should be considered in patients with breast cancer who have increased size and radiotracer uptake in ovarian tissue on follow-up 18F-FDG PET/CT scans.
Keywords:
Breast carcinoma, 18F-FDG PET/CT, unilateral ovarian metastasis, isolated ovarian metastasis, ovarian uptake
Ethics
Informed Consent: The informed consent was obtained from the patient.
Authorship Contributions
Surgical and Medical Practices: N.A.D., Concept: E.T., Design: D.Ç., Data Collection or Processing: Ö.Ö., Analysis or Interpretation: D.Ç., Ö.Ö., Literature Search: E.T., Writing: N.A.D.
Conflict of Interest: No conflicts of interest were declared by the authors.
Financial Disclosure: The authors declare that this study has received no financial support.
References
1DiPiro PJ, Tirumani SH, Cruz GP, Ramaiya NH, Lester SC, Shinagare AB. Lobular breast cancer: patterns of intraabdominal metastatic spread on imaging and prognostic significance. Abdom Radiol (NY). 2019;44:362-369.
2Kutasovic JR, McCart Reed AE, Males R, Sim S, Saunus JM, Dalley A, McEvoy CR, Dedina L, Miller G, Peyton S, Reid L, Lal S, Niland C, Ferguson K, Fellowes AP, Al-Ejeh F, Lakhani SR, Cummings MC, Simpson PT. Breast cancer metastasis to gynaecological organs: a clinico-pathological and molecular profiling study. J Pathol Clin Res. 2019;5:25-39.
3Kubeček O, Laco J, Špaček J, Petera J, Kopecký J, Kubečková A, Filip S. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017;34:295-307.
4Roseland ME, Millet JD, Wasnik AP. Imaging of metastatic disease to the ovary/adnexa. Magn Reson Imaging Clin N Am. 2023;31:93-107.
5Tian W, Zhou Y, Wu M, Yao Y, Deng Y. Ovarian metastasis from breast cancer: a comprehensive review. Clin Transl Oncol. 2019;21:819-827.
6Pimentel C, Becquet M, Lavoue V, Henno S, Leveque J, Ouldamer L. Ovarian metastases from breast cancer: a series of 28 cases. Anticancer Res. 2016;36:4195-4200.
7Hogan MP, Goldman DA, Dashevsky B, Riedl CC, Gonen M, Osborne JR, Jochelson M, Hudis C, Morrow M, Ulaner GA. Comparison of 18F-FDG PET/CT for systemic staging of newly diagnosed invasive lobular carcinoma versus invasive ductal carcinoma. J Nucl Med. 2015;56:1674-1680.
