NEWS
Positron Emission Tomography (PET) and Computed Tomography (CT) have been in existence for years; however, with financing available, it is now party of most Physician's daily practice in diagnosing, staging and restaging malignancies.
Case of the Month
By Stephen R. Bunker, M.D.
Bladder Cancer - Staging
12.20.05 - 58 year old male presented with a history of bladder cancer status post resection and subsequent chemotherapy 6 years earlier.
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CASE OF THE MONTH
58 year old male presented with a history of bladder cancer status post resection and subsequent chemotherapy 6 years earlier. He developed right knee pain and underwent a right knee arthroscopy. It did not help and neurologic symptoms in the right leg progressed with numbness and weakness. An MRI demonstrated an L3 collapsed vertebral body with probable tumor involvement which was confirmed through biopsy. Radiation therapy was started. He was then referred to assess the extent of the disease and to detect possible primary site.
PET Impressions were as follows:
1. L2,3,4 metastases, with collapse of the L3 vertebral body (known from MRI)
2. Post-surgical changes in pelvis, with right hemipelvic osseous metastases and ? mid-pelvic LN metastasis (undetected by CT).
3. Large left supraclavicular soft tissue mass, most likely LN metastasis (not included in CT field of view).
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