Diagnostics (Sep 2022)

Focal Uptake in the Sternum on <sup>18</sup>F-FDG-PET/CT Caused by G-CSF Therapy after Chemotherapy Mimicking Bone Metastasis of Breast Cancer

  • Kumiko Hayashi,
  • Tomoyuki Fujioka,
  • Masatake Hara,
  • Yuichi Kumaki,
  • Goshi Oda,
  • Emi Yamaga,
  • Mio Mori,
  • Iichiroh Ohnishi,
  • Kazunori Kubota,
  • Tsuyoshi Nakagawa

DOI
https://doi.org/10.3390/diagnostics12102308
Journal volume & issue
Vol. 12, no. 10
p. 2308

Abstract

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A woman in her 70s was diagnosed with left breast cancer and left axillary lymph node metastasis by an ultrasound-guided biopsy. 18F-FDG-PET/CT showed strong FDG accumulation in the tumor in the left breast and a left axillary lymph node. Neoadjuvant chemotherapy (NAC) was administered in combination with a G-CSF injection to prevent febrile neutropenia. The post-treatment 18F-FDG-PET/CT showed the disappearance of the left breast tumor and left axillary lymph node and revealed a solitary new area of strong FDG accumulation in the sternum. To rule out the possibility of sternal metastasis, a sternal biopsy was performed at the same time as surgery, which revealed no malignant findings. Although very rare, focal uptake on 18F-FDG-PET/CT performed after anticancer drug therapy with G-CSF may mimic a solitary bone metastasis. A bone biopsy may be a useful technique to avoid an immediate misdiagnosis of bone metastasis.

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