Göðüs Hastanesi Dergisi. 2023; 37(3): 139-142 | DOI: 10.14744/IGH.2023.77487

Akciðer Kanseri Takibinde Pozitif FDG – PET BT: Benign Talkoma Olabilir Mi?

Bahar Aðaoðlu Þanlý¹, Serkan Yazgan¹, Seher Susam², Ahmet Üçvet^1
1Saðlýk Bilimleri Üniversitesi, Ýzmir Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Cerrahisi Kliniði, Ýzmir, Türkiye
²Saðlýk Bilimleri Üniversitesi, Ýzmir Dr. Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Radyoloji Anabilim Dalý, Ýzmir, Türkiye

Talk plörodezi, sýklýkla sekonder pnömotoraks veya malign plevral efüzyon vakalarýnda adezyonu arttýrmak için plevral inflamatuar reaksiyonu indüklemek amacýyla yapýlýr. Öyküsünde 16 yýl önce sað sekonder pnömotoraks ve tüp torakostomi olan hastada, sol üst lobda akciðer kanseri tespit edildi ve video yardýmlý torasik cerrahi (VATS) yöntemi kullanýlarak sol üst lobektomi yapýldý. Bu ameliyattan üç ay sonra sað akciðerde tekrarlayan pnömotoraks saptandý ve hasta tüp torakostomi yapýlarak talk plörodezi ile tedavi edildi. Hastanýn rutin onkolojik takibinin altýncý ayýnda çekilen PET-BT’de sað tarafta, plevra ve anterior mediastende FDG tutulumu saptandý. Talk plörodezinin iþlemden 5 yýl sonrasýna kadar PET-BT’de hipermetabolik plevral kalýnlaþmaya neden olduðunu bildiren yayýnlar mevcuttur. Bu olasýlýðýn farkýnda olmak, plevral tutulumu ve hipermetabolik anterior mediastinal kitle imajý olan hastalarý geçmiþ iþlemler hakkýnda sorgulamak ve metabolik görüntülemeyi yorumlayan hekimi bu tür iþlemler hakkýnda bilgilendirmenin önemini vurgulamak amacýyla olgumuzu sunuyoruz.

Anahtar Kelimeler: Akciðer kanseri, PET-BT, talk plörodezi, talkoma.

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Positive FDG in Lung Cancer Follow-up – PET CT: Can There Be Benign Talcoma?

Bahar Aðaoðlu Þanlý¹, Serkan Yazgan¹, Seher Susam², Ahmet Üçvet^1
1Department of Thoracic Surgery, University of Health Sciences, Ýzmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Ýzmir, Türkiye
²Department of Radiology, University of Health Sciences, Ýzmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Ýzmir, Türkiye

Talc pleurodesis is often performed in cases of secondary pneumothorax or malignant pleural effusion with the aim of inducing a pleural inflammatory reaction to increase adhesion. FDG-PET (fluorodeoxyglucose positron emission tomography) is used in oncology for diagnosis, staging, restaging, and evaluation of treatment response. A patient with a history of right secondary pneumothorax and tube thoracostomy 16 years ago had lung cancer in the left upper lobe, and left upper lobectomy was performed using video-assisted thoracic surgery (VATS). Three months after this operation, recurrent pneumothorax was detected in the right lung, and the patient was treated with talc pleurodesis by performing tube thoracostomy. On the PET-CT taken in the sixth month of the patient’s routine oncological follow-up, FDG uptake was detected on the right side, pleura, and anterior mediastinum. There are publications reporting that talc pleurodesis can cause hypermetabolic pleural thickening in PET-CT up to 5 years after the procedure. We present our case to highlight the importance of being aware of this possibility, to question patients with pleural involvement and hypermetabolic anterior mediastinal mass images about past procedures, and to emphasize the importance of informing colleagues responsible for interpreting metabolic imaging about such procedures.

Keywords: Lung cancer, PET-CT, talc pleurodesis, talcoma.

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