Anales de la RANM

92 A N A L E S R A N M R E V I S T A F U N D A D A E N 1 8 7 9 CONTRIBUTION OF 18F-FDG PET/CT IN OCCULT BREAST CARCINOMA Valhondo-Rama, et al. An RANM. 2021;138(01): 92 - 95 DOI: 10.32440/ar.2021.138.01. rev10 Enviado: 24.03.21 | Revisado: 30.03.21 | Aceptado: 25.04.21 R E V I S I Ó N Abstract Early detection of primary lesion with isolated axillary lymph node metastasis without any clinical or radiological evidence of tumour is still a pending issue. It is important to offer these patients a better management and survival. The defini- tion of occult breast carcinoma is redefined as radiological diagnostic techniques progress. We emphasize the contribution of whole-body fluorine-18 fluorodeoxyglu- cose positron emission tomography associated with computed tomography for staging, surgical approach and adjuvant treatments recommendations for these patients. Resumen La detección precoz de la lesión primaria en casos de metástasis aisladas de ganglios linfáticos axilares, sin evidencia clínica ni radiológica de tumor, sigue siendo una cuestión pendiente de resolver. Sin embargo, es importante para ofrecer a estos pacientes un mejor manejo y mayor supervivencia. La definición de carcinoma oculto de mama se redefine a medida que avanzan las técnicas radiológicas de imagen diagnóstica. Con este trabajo queremos resaltar la aportación de la tomografía por emisión de positrones con flúor-18 fluorodeoxiglucosa asociada a tomografía computarizada de cuerpo entero para la estadificación, el abordaje quirúrgico y las recomendaciones de tratamientos adyuvantes en estos pacientes. Keywords: Axillary adenopathies; Breast Carcinoma; Positron Emission Tomography; Staging. Palabras clave: Adenopatías axilares; Carcinoma de mama; Tomografía de emisión de positrones; Estadificación. Autor para la correspondencia Raquel Valhondo-Rama C/ Sagrados Corazones, 6, 4A · 28011 Madrid Tlf.: +34 616 034 589 E-Mail: r.valhondorama@gmail.com Valhondo-Rama, Raquel 1 ; Brenes Sánchez, Juana M 2 , Wakfie-Corieh, Cristina G 1 ; Rodríguez Rey, Cristina 1 ; Herrera De la Muela, María 2 ; Carreras Delgado, José L 1 1 Department of Nuclear Medicine, Hospital Clínico San Carlos, Madrid. 2 Department of Obstetric and Gynaecology, Hospital Clínico San Carlos, Madrid. CONTRIBUTION OF 18F-FDG PET/CT IN OCCULT BREAST CARCINOMA APORTACIÓN DE LA 18F-FDG PET/TC EN TUMORES OCULTOS DE MAMA Thanks to advances in diagnostic techniques the incidence of occult breast carcinoma (OBC) has significantly decreased, today estimated in 0,3-1% of breast cancers overall.(1–7) Nowadays, a patient has OBC when presenting metastatic axillary lymphadenopathies without palpable tumour in the ipsilateral breast, a non-diagnostic radiological assessment for breast tumour and no other primary neoplasm detected outside the breast which may potentially affect the axillary lymph nodes.(4,8) The final diagnosis is based on the histopathological findings and the immunohistochemistry. Lymphoma is the most common malignant cause of axillary lymphadenopathy followed by breast carcinoma. Less common primary tumours which can metastasize to axillary lymph nodes are thyroid, lung, stomach, pancreas, ovary, colon and various sarcomas.(1,3,5) There are also some theories that explain this carcinoma arising f rom ectopic breast tissue due to a failure of resolution of the embr yologic mammar y ridge, so it could be classif ied as primar y OBC in axillar y lymph nodes instead of metastatic OBC, with dif ferent management. (5,8,9) Clinical examination, breast ultrasound (US), mammography (MM), contrast-enhanced CT, magnetic resonance imaging (MRI), fine needle aspiration cytology (FNAC) and biopsy are the most frequently tests used for searching the primary lesion(1–3) but whole-body fluorine-18 fluorodeoxyglucose positron emission tomography associated with computed tomography (WB 18 F- FDG PET/CT) has its role too. We describe here how the findings on WB 18 F-FDG PET/CT represented a change in the staging and/ or in the therapeutic management in two patients with OBC in our Centre. INTRODUCTION