Fluoro-deoxy-glucose-(18f) Positron Emission Tomography in Diagnostic of Carcinoma of Unknown Origin
Carcinoma of unknown origin is defined as the absence of primary tumor and biopsy proved the existence of metastatic changes. The incidence is about 3% of all cancers. We present a case of a patient who underwent surgery for left breast mammography verified pathological lymphonodes on the left breast and on the left axillary region. Histopathological analysis of excised tissue showed the absence of malignant disease in the breast. A complete diagnostic evaluation also did not confirm the primary lesion. We done fluorodeoxyglucosa positron emission tomography, which had set suspicion of primary breast cancer, but biopsy and pathological reverification were not confirmed. The patient spent six cycles of chemotherapy for cancer of unknown origin. After a year and six months because of sudden right side hemiparesis were performed Computed Tomography and Magnetic Resonance imaging of the head, which indicated that it was a metastatic brain tumour. After metastasectomy, histopathological finding was finally proved to be a metastasis of breast adenocarcinomas. The patient had irradiation of the cranium, and began chemotherapy protocol for breast cancer. In this case, insufficient diagnosis did not affect in the proper therapeutic approach.