Clinical History

The patient is a 47-year-old female with a history of metastatic breast cancer. Recently cutaneous metastases were noted on the chest wall. The CT of the abdomen and pelvis were interpreted as normal. The CT of the chest showed "occasional" lymph nodes in the right axilla, but were within normal limits. The bone scan was interpreted as normal, except for three possible rib fractures in the right rib cage. We have been asked to examine the patient for the possibility of distant metastases.

Technique

The patient received an intravenous injection of 10 millicuries of F18-FDG and approximately an hour later whole body PET imaging was obtained from the base of the skull to the upper femurs.

Findings

Multiple metastases are identified in axillae, thoracic and lumbar vertebrae, right anterior chest wall inferiorly, the anterolateral abdominal wall, iliac nodes, right and left ischium, right and left femurs, wing of the right ilium and probably the left adrenal gland.

Impressions

MULTIPLE METASTASES INVOLVING THE THORAX, ABDOMEN, PELVIS, AS DESCRIBED ABOVE.

Comments

The patient would have gone untreated based upon the results of the CT scan and the Bone scan. PET definately impacted the healthcare, and the life of this patient

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