1
|
Wang J, Wu R, Liu F, Yang L, Hu F, Wu Z, Gao Z, Xia X. Case Report: Lung Adenocarcinoma Initially Presenting With Cutaneous and Subcutaneous Metastases. Front Oncol 2022; 12:925382. [PMID: 35903702 PMCID: PMC9316617 DOI: 10.3389/fonc.2022.925382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/23/2022] [Indexed: 11/19/2022] Open
Abstract
Cutaneous and subcutaneous soft tissue metastases are rare in lung adenocarcinoma and suggest poor prognosis. We report a patient with lung adenocarcinoma who initially presented with cutaneous and subcutaneous metastases to the abdomen that were initially presumed to be herpes zoster and an occult subcutaneous soft tissue mass. Because the lesions progressed over 3 weeks despite routine herpes zoster treatment, magnetic resonance imaging was performed and showed a presumed sarcoma; however, 18F-fluourodeoxyglucose positron emission tomography/computed tomography demonstrated pulmonary lesions. Biopsy of the abdominal lesion confirmed poorly differentiated lung adenocarcinoma. Early diagnosis of soft tissue metastasis can be difficult. Clinicians should suspect internal organ malignancy when a progressive cutaneous or subcutaneous soft tissue lesion is encountered.
Collapse
Affiliation(s)
- Jingjing Wang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
| | - Ruolin Wu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
| | - Fang Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Hu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
| | - Zhijian Wu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
| | - Zairong Gao
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Key Laboratory of Biological Targeted Therapy, the Ministry of Education, Wuhan, China
- *Correspondence: Zairong Gao, ; Xiaotian Xia,
| | - Xiaotian Xia
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nuclear Medicine, The People’s Hospital of Honghu, Honghu, China
- *Correspondence: Zairong Gao, ; Xiaotian Xia,
| |
Collapse
|
2
|
Liu Y, Yin Z, Li X, Zhang Y, Yuan Y, Wei L, Wang S. The diagnostic accuracy of intravoxel incoherent motion and diffusion kurtosis imaging in the differentiation of malignant and benign soft-tissue masses: which is better? Acta Radiol 2022; 63:785-793. [PMID: 34000824 DOI: 10.1177/02841851211017511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It is difficult for conventional magnetic resonance imaging (MRI) to distinguish benign soft-tissue masses (STMs) from malignant masses. PURPOSE To quantitatively compare the diagnostic value of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in STMs. MATERIAL AND METHODS The data from 58 patients with STMs were retrospectively analyzed. The GE Discovery 3.0-T MRI scanner was used to acquire conventional MRI sequences, IVIM, and DKI images. The chi-square test, independent sample t-test, and Mann-Whitney U tests were used to compare the differences between conventional MRI features, IVIM, and DKI parameters (Dslow, Dfast, f, mean kurtosis [MK], and mean diffusivity [MD]) between the benign and malignant groups. Receiver-operating characteristic (ROC) curve analysis was also performed. RESULTS Tumor size and depth are statistically different in STTs. Dslow, MK, and MD values in the malignant groups are significantly lower than the benign groups (P < 0.05). However, Dfast and f values are not statistically different between the two groups. The area under the curve (AUC) of Dslow value (0.859) is higher than MD (0.765) and MK (0.676) values for identifying benign and malignant STMs. The Dslow value showed the best specificity (82.93%). The sensitivity and specificity of IVIM and DKI parameters are higher than that of conventional MRI sequences. CONCLUSION IVIM and DKI can be used to distinguish between benign and malignant STMs, with Dslow as the most meaningful parameter.
Collapse
Affiliation(s)
- Yajie Liu
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Zhenzhen Yin
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Xiangwen Li
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Yu Zhang
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Yuan Yuan
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Lai Wei
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| | - Shaowu Wang
- Department of Radiology, The Second Hospital, Dalian Medical University, Shahekou, Dalian, PR China
| |
Collapse
|