Clinical Image
J Mol Biol & Mol Imaging. 2016; 3(1): 1027.
Molecular Imaging Demonstrates Metastatic Snowstorm in Cancer of Unknown Primary Site
McKay JN¹, McAuley I², McKay TM² and McKay MJ3,4*
¹Monash University, Clayton Campus, Melbourne Australia
²Deakin University, Burwood Campus, Melbourne Australia
³North Coast Cancer Institute, Lismore NSW Australia
4University of Sydney, Camperdown NSW Australia
*Corresponding author: Michael J McKay, North Coast Cancer Institute, Lismore NSW 2480, Australia
Received: November 29, 2016; Accepted: December 05, 2016; Published: December 07, 2016
Clinical Image
A previously well 45 year old female presented with intensifying knee and pelvic pain and bilaterally enlarged cervical lymph nodes. Core biopsy of a right cervical lymph node was consistent with metastatic poorly differentiated squamous cell carcinoma, but no primary site was evident at presentation or throughout the course of her illness. Clinically and radiologically the greatest bulk of disease was in the right neck and upper mediastinum. Whole body FDGPET/ CT showed a plethora (208 in toto) of bony and soft-tissue metastases, to our knowledge the largest number of metastatic lesions recorded in any one patient (Figure 1).
She received palliative chemotherapy and radiotherapy, with some symptomatic relief.
Question: What is the most common, adeno- or squamous cellcarcinoma of unknown primary site?
Answer: The former.
Question: How common is metastatic epithelial malignancy below the elbows and knees?
Answer: Uncommon, especially in oligometastatic disease, but more common when widespread, as shown here.
McKay JN, McAuley I, McKay TM and McKay MJ. Molecular Imaging Demonstrates Metastatic Snowstorm in Cancer of Unknown Primary Site. J Mol Biol & Mol Imaging. 2016; 3(1): 1027.
Figure 1:
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