미만성 전이를 보인 성인 비부비동 폐포형 횡문근육종의 $^{18}F$-FDG PET/CT, CT 및 MR 영상소견: 2예 보고

The CT and MR Imaging Findings of Adulthood Sinonasal Alveolar Rhabdomyosarcoma with Disseminated Metastases on $^{18}F$-FDG PET/CT: Report of Two Cases

  • 반영은 (계명대학교 의과대학 동산의료원 영상의학과) ;
  • 이상권 (계명대학교 의과대학 동산의료원 영상의학과)
  • Bahn, Young-Eun (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, Sang-Kwon (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine)
  • 발행 : 2011.02.01

초록

저자들은 $^{18}F$-FDG PET/CT에서 강한 대사활성도와 미만성 전이를 보였던 성인에서 발병한 비부비동 폐포형 횡문근육종 2예를 보고하고자 한다. 이들 종양들은 조영증강 후 CT 및 T1-강조영상에서 포도송이 모양의 테두리형 조영증강을 보였다("botryoid sign"). 비부비동 종괴가 조영증강 후 CT 및 T1-강조영상에서 "botryoid sign"을 보이며, $^{18}F$-FDG PET/CT에서 강한 대사활성도 및 미만성 전이를 동반할 경우 성인에서 발병한 횡문근육종을 고려하여야 한다.

We report herein two cases of adulthood sinonasal alveolar rhabdomyosarcoma that showed intense hypermetabolism and disseminated metastasis on $^{18}F$-FDG PET/CT. The contrast-enhanced CT (CECT) and gadolinium-enhanced T1-weighted images(Gd-T1WI) showed multiple rings of intense enhancement (the "botryoid sign") of the mass. Adulthood rhabdomyosarcoma should be considered when a sinonasal massshows the "botryoid sign" on CECT or Gd-T1WI, and intense hypermetabolism with disseminated metastases on 18F-FDG PET/CT.

키워드

참고문헌

  1. Feldman BA. Rhabdomyosarcoma of the head and neck. Laryngoscope 1982;92:424-440
  2. La Quaglia MP, Heller G, Ghavimi F, Casper ES, Vlamis V, Hajdu S, et al. The effect of age at diagnosis on outcome in rhabdomyosarcoma. Cancer 1994;73:109-117 https://doi.org/10.1002/1097-0142(19940101)73:1<109::AID-CNCR2820730120>3.0.CO;2-S
  3. Tateishi U, Hosono A, Makimoto A, Nakamoto Y, Kaneta T, Fukuda H, et al. Comparative study of FDG PET/CT and conventional imaging in the staging of rhabdomyosarcoma. Ann Nucl Med 2009;23:155-161 https://doi.org/10.1007/s12149-008-0219-z
  4. Klem ML, Grewal RK, Wexler LH, Schoder H, Meyers PA, Wolden SL. PET for staging in rhabdomyosarcoma: an evaluation of PET as an adjunct to current staging tools. J Pediatr Hematol Oncol 2007;29:9-14 https://doi.org/10.1097/MPH.0b013e3180307693
  5. Peng F, Rabkin G, Muzik O. Use of 2-deoxy-2-[F-18]-fluoro-D-glucose positron emission tomography to monitor therapeutic response by rhabdomyosarcoma in children: report of a retrospective case study. Clin Nucl Med 2006;31:394-397 https://doi.org/10.1097/01.rlu.0000222954.38724.be
  6. Iagaru A, Goris ML. Rhabdomyosarcoma diffusely metastatic to the bone marrow: suspicious findings on 99mTc-MDP bone scintigraphy confirmed by (18)F-18 FDG PET/CT and bone marrow biopsy. Eur J Nucl Med Mol Imaging 2008;35:1746 https://doi.org/10.1007/s00259-008-0864-4
  7. Seshadri N, Wright P, Balan KK. Rhabdomyosarcoma with widespread bone marrow infiltration: beneficial management role of F-18 FDG PET. Clin Nucl Med 2007;32:787-789 https://doi.org/10.1097/RLU.0b013e318148b434
  8. Hagiwara A, Inoue Y, Nakayama T, Yamato K, Nemoto Y, Shakudo M, et al. The "botryoid sign": a characteristic feature of rhabdomyosarcomas in the head and neck. Neuroradiology 2001;43:331-335 https://doi.org/10.1007/s002340000464
  9. Enzinger FM, Weiss SW. Soft tissue tumors. 3rd ed. St Louis: Mosby, 1995:539-577
  10. Ihara T, Okamura D, Takahashi N, Kohri M, Kayano H, Tamaru J, et al. Alveolar rhabdomyosarcoma mimicking nasal lymphoma at the initial presentation. J Clin Exp Hematop 2008;48:61-64 https://doi.org/10.3960/jslrt.48.61