Extensive Skeletal Muscle Metastases in Malignant Pleural Mesothelioma Detected by FDG PET/CT

Abstract

Malignant pleural mesothelioma (MPM) is a rare but aggressive tumor originating from pleural mesothelial cells. Distant skeletal muscle metastasis is rare in MPM. A 54-year-old woman was diagnosed with epithelioid MPM and treated with surgery, chemotherapy, and radiotherapy 2 years ago. During follow-up, diffuse irregular pleural thickening with focal chest wall invasion in the right hemithorax and two small pleural thickenings in the left hemithorax were seen on control diagnostic contrast-enhanced computed tomography (CECT). Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (FDG PET/CT) imaging was performed as part of restaging. PET showed diffusely increased FDG uptake in the recurrent right pleural tumor, and two hypermetabolic small metastatic foci in the contralateral pleura. In addition, multiple hypermetabolic areas of various sizes in various skeletal muscle localizations, suggestive of extensive muscle metastases were noted. Histopathologic study confirmed metastatic epithelioid MPM. FDG PET/CT revealed multiple muscle metastases which were not observed on earlier CECT and contributed to the visualization of more extensive metastatic involvements in the presented case with MPM. FDG PET/CT can detect rarely seen skeletal muscle metastases that are not visualized on diagnostic CT, and provides more accurate restaging of MPM.

Keywords

malignant pleural mesothelioma - skeletal muscle metastasis - FDG PET/CT - contrast-enhanced CT

Authors' Contributions

M.Y. has roles in acquisition, interpretation of PET/CT data, and writing the manuscript. O.K. has roles in analyzing of clinical data and writing the manuscript. E.T. has a role in reporting histopathological study and writing the manuscript. All authors have final approval of the manuscript to be published.

Note

This paper was presented at the International Congress of Health Research (ICOHER 2022), Proceedings Book, October 12 to October 15, 2022, conducted online (http://www.icoher.org).

Publikationsverlauf

Artikel online veröffentlicht:
04. Dezember 2023

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