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These lymphadenopathies should be cancer metastases. There was a hypermetabolic mass in the left part of the vagina in addition, with a SUVmax of 10.8, but no abnormality in the corresponding site on full dose CT component of PET/CT. Another abnormal lymph node could be found in the right lung hilum, with short axis and SUVmax of 10mm and 4.2 respectively. According to the lymphatic drainage path of rectum, the hilar lymphadenopathy was more likely to be reactive hyperplasia." ] ] ] "textoCompleto" => "A 47-year-old woman complaining perineal discomfort for one month was admitted to our hospital. She had received a Miles radical resection for low rectal cancer 9 months earlier. The tumor was a moderately differentiated adenocarcinoma and qualified as T2N2aM0 (stage IIIB) disease by the 8th edition of the AJCC Cancer Staging Manual. Immunohistochemical results demonstrated the tumor cells were positive for CK20, Villin and CDX-2, but negative for CK7. Then, she received 6 cycles of oxaliplatin-based adjuvant chemotherapy with CapeOx regime. The last dose was administered 4 months ago. Because of perineal discomfort, she received unenhanced 18F-FDG PET/CT scanning for cancer surveillance. Her serum tumor makers (including CEA, CA-125, CA15-3 and CA19-9) test prior to PET/CT were negative. The PET/CT images revealed there were multiple lymphnode metastases along the left iliac vessels. There was a hypermetabolic mass in the left part of the vagina in addition, but no abnormality in the corresponding site on full dose CT component of PET/CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Subsequent physical examination found a mass in the lower part of the vagina. Histopathological study after biopsy confirmed the presence of moderately differentiated adenocarcinoma. Immunohistochemical results demonstrated the tumor cells were positive for CK20, Villin and CDX-2, P16 and EMA, but negative for CK7, Pax-8, ER and PR, which were compatible with the rectal origin. She got remission after receiving more 2 cycles of XELOX regime chemotherapy and concurrent radiotherapy. The patient was still in treatment at the time of report.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Colorectal cancer is one of the most frequently diagnosed cancer and one of the leading cause of cancer death wordwide. The metastases are most frequently in the liver, pelvic and abdomen lymph nodes and lungs. The incidence of metastatic vaginal tumor was less than 0.03%. The most of them arose from uterus (65.9%), ovary (14.0%) and colorectum (8.5%).<a class="elsevierStyleCrossRef" href="#bib0020">1</a> Unlike the metastasis from gynecologic cancer, vaginal metastasis from colorectal cancer can present as possible primary lesion and be diagnosed before the colorectal primary lesion is diagnosed.<a class="elsevierStyleCrossRefs" href="#bib0020">1,2</a> It is difficult in clinical practice to discover a cancer metastasized to uncommon site on conventional imaging, especially for a patient with nonspecific complaint. 18F-FDG PET/CT can compensate for this limitation. It could detect 32% more extrahepatic metastasis than conventional imaging.<a class="elsevierStyleCrossRef" href="#bib0030">3</a> Information from PET/CT may result in a change in colorectal cancer management.<a class="elsevierStyleCrossRef" href="#bib0030">3</a> This whole body imaging method may be suitable for routine initial staging and post-treatment cancer surveillance, especially on a patient with clinical advanced stage or suspicion of recurrence. It is particularly hard to distinguish distant metastasis by an unusual source from a synchronous or metachronous primary cancer base on imaging only. But given to the primary vaginal carcinoma accounts for only 2% of all gynecologic malignancies and the detection of metastatic vaginal cancer may precede it is colorectal primary, when a vaginal tumor is shown to be hypermetabolic on PET/CT, metastasis should be in the scope of differential diagnosis.<a class="elsevierStyleCrossRef" href="#bib0025">2</a>Conflict of interestNone declared." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Fan Q, Huang D, Su M. Metástasis vaginal por cáncer de recto detectada por 18F-FDG PET/TC. Rev Esp Med Nucl Imagen Mol. 2020;39:42–43." ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1778 "Ancho" => 2370 "Tamanyo" => 326392 ] ] "descripcion" => array:1 [ "en" => "The maximum intensity projection PET (A), axial fusion (B–D) and CT (E–G) images revealed there were multiple FDG avid lymphnodes along the internal and external iliac vessels, with short axis and SUVmax of 15mm and 6.4 respectively. These lymphadenopathies should be cancer metastases. There was a hypermetabolic mass in the left part of the vagina in addition, with a SUVmax of 10.8, but no abnormality in the corresponding site on full dose CT component of PET/CT. Another abnormal lymph node could be found in the right lung hilum, with short axis and SUVmax of 10mm and 4.2 respectively. According to the lymphatic drainage path of rectum, the hilar lymphadenopathy was more likely to be reactive hyperplasia." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastases to the female tract. Analysis of 325 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.T. Mazur" 1 => "S. Hsueh" 2 => "D.J. Gersell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/1097-0142(19840501)53:9<1978::aid-cncr2820530929>3.0.co;2-1" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1984" "volumen" => "53" "paginaInicial" => "1978" "paginaFinal" => "1984" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6322966" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vaginal metastases from colorectal cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.J. Ng" 1 => "E.H. Aly" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijsu.2013.09.004" "Revista" => array:6 [ "tituloSerie" => "Int J Surg" "fecha" => "2013" "volumen" => "11" "paginaInicial" => "1048" "paginaFinal" => "1055" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24076094" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy and impact on management of (18)F-FDG PET and PET/CT in colorectal liver metastasis: a meta-analysis and systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.M. Maffione" 1 => "E. Lopci" 2 => "C. Bluemel" 3 => "F. Giammarile" 4 => "K. Herrmann" 5 => "D. Rubello" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00259-014-2930-4" "Revista" => array:6 [ "tituloSerie" => "Eur J Nucl Med Mol Imaging" "fecha" => "2015" "volumen" => "42" "paginaInicial" => "152" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25319712" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003900000001/v1_202001150636/S225380891930045X/v1_202001150636/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003900000001/v1_202001150636/S225380891930045X/v1_202001150636/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225380891930045X?idApp=UINPBA00004N"]

ISSN: 2253-8089

The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.

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1.6

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1.1

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0.208

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0.273

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