Pleural Mesothelioma Detects by 18F-Choline PET/CT in a Patient With Biochemical Recurrence of Prostate Cancer

Our plain-English summary of Pleural Mesothelioma Detects by 18F-Choline PET/CT in a Patient With Biochemical Recurrence of Prostate Cancer, by M. Rensi, G. Ferretti, F. Di Gregorio, et al (Clinical Nuclear Medicine, 2019).

The study

• Authors: M. Rensi, G. Ferretti, F. Di Gregorio, L. Evangelista
• Journal: Clinical Nuclear Medicine
• Published: 2019;44(2):e116-e117
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 73-year-old man with a prostate cancer treated by radical prostatectomy in 2006. For a biochemical recurrence of disease (prostate-specific antigen level, 0.1 ng/mL) during hormonal therapy, patient underwent F-choline PET/CT that showed a significant uptake in a diffuse right pleural thickening. The patient was sent to pleurectomy decortication showing an epithelioid pleural mesothelioma. This case highlighted that a histopathological evaluation is mandatory in case of a significant radiolabeled choline uptake in pleural lesions.

In plain English

This is a short case report, published as an "Interesting Image," about one 73-year-old man. He had a history of myocardial infarction, coronary revascularization in 2001, and prostate cancer treated by radical prostatectomy in 2006. In May 2018, while he was on hormonal therapy, his prostate-specific antigen (PSA) level had increased (0.1 ng/mL), so he had an 18F-choline PET/CT scan. The scan showed high tracer uptake in a diffuse thickening of the pleura (the lining around the lung) on the right side, mainly in the upper regions. The highest uptake value (SUVmax) was 7.8. The scan also showed a significant pleural effusion (fluid around the lung). No other abnormal uptake was seen. Two months later he had pleurectomy decortication surgery, and tissue examination showed epithelioid pleural mesothelioma. He then received adjuvant chemotherapy with platinum plus a second drug that the article spells "petremexed." The article does not mention asbestos or any other exposure. The authors concluded that tissue examination should be mandatory when pleural thickening shows choline uptake on PET/CT, to tell pleural mesothelioma apart from other conditions.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient, "Interesting Image" format)
• Who was studied: one 73-year-old man with a history of myocardial infarction, coronary revascularization in 2001, and prostate cancer treated by radical prostatectomy in 2006 (pT2cN0M0; Gleason score 7); the authors are from nuclear medicine units in Udine and Padua, Italy
• Exposure: the article does not report asbestos or any other exposure; the case concerns imaging with 18F-choline PET/CT done because of rising PSA
• Main results:
  • In May 2018, because PSA had increased (0.1 ng/mL) during hormonal therapy, the patient had 18F-choline PET/CT
  • The scan showed high uptake in a diffuse pleural thickening in the right hemithorax, mainly the upper regions
  • The maximum standardized uptake value (SUVmax) in this patient's pleural thickening was 7.8
  • A significant pleural effusion was seen on the CT images
  • No other abnormal 18F-choline uptake was seen
  • Two months after the scan the patient had pleurectomy decortication, and histology showed epithelioid pleural mesothelioma
  • The patient was treated with adjuvant chemotherapy, platinum plus a drug printed as "petremexed"
• The authors' conclusion: The authors concluded that histopathological evaluation should be mandatory when pleural thickening shows positive choline uptake on PET/CT, to distinguish pleural mesothelioma from other conditions

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Pleural Thickening, Epithelioid.

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