宫颈小细胞神经内分泌癌伴多发转移^18F-FDGPET／CT显像一例

Small cell neuroendocrine carcinoma of the cervix with multiple metastases： ^18F-FDG PET/ CT findings

笔者报道了一例以头痛7d伴右颅顶部质硬包块为首发表现的宫颈小细胞癌病例。颅脑CT平扫示右顶叶高密度结节伴周围低密度水肿带、邻近颅骨骨质破坏，考虑颅内肿瘤性病变。颅脑MRI示右顶叶稍长T1、T2信号结节伴水肿带，增强扫描后病灶明显强化。18SF-FDGPET／CT全身显像示宫颈软组织团块伴高代谢、双侧盆腔淋巴结高代谢、全身多处骨骼包括右颅顶部病灶骨质破坏伴高代谢。宫颈活检病理结果确诊为小细胞癌。文献复习加深了对宫颈小细胞癌的认识，其发病率极低，临床表现缺乏特异性，早期不易被发现，该病侵袭性强，易发生淋巴结和血行转移，预后较差。^18F-FDGPET／CT对官颈小细胞癌的原发灶、淋巴结转移、骨转移及其他较隐匿部位转移病灶的探测灵敏度较高，在该病的临床管理中具有较好的应用价值。

The author reports a case of small cell carcinoma of the cervix. The patient had a 7-day history of headache and a hard mass in the parietal region of the cranium on the right side as the first manifestation. Cranial CT scan showed a high-density nodule on the right parietal lobe, with a surrounding low-density edema and adjacent skull bone destruction; thus, intracranial tumor was considered. MRI brain scan showed a slightly longer T1 and T2 signal nodule, with edema in the right parietal lobe. The lesion was significantly enhanced after the application of contrast. The ^18F-FDG PET/CT whole-body imaging showed a solid mass of cervix and slightly large bilateral pelvic lymph nodes and presented multiple bone destruction with high FDG uptake. The histopathological examination revealed small cell carcinoma of the cervix. Small cell carcinoma of the cervix has extremely low incidence, its clinical manifestation lacks specificity, and it is not easily detected at its early stage. Small cell carcinoma of the cervix is an aggressive tumor and commonly have early metastasis through lymph node and blood circulation, with a poor prognosis. The sensitivity of 18F-FDG PET/CT in detecting primary lesions and metastases, including lymph node, bone, and other occult lesions, is high. Thus, this method is valuable in the clinical management of the small cell carcinoma of the cervix.