title: Occult metastatic lung carcinoma presenting as locally advanced uterine carcinosarcoma on positron emission tomography/computed tomography imaging.
abstract: Increasingly, positron emission tomography/computed tomography (PET/CT) is being used as a tumor surveillance modality for multiple tumor types. A 73-year-old postmenopausal female with stage IV nonsmall cell lung cancer presented after a PET/CT demonstrated focal uptake in the superior and lateral aspects of the uterus. The patient reported a history of intermittent postmenopausal bleeding and an endometrial biopsy documented uterine carcinosarcoma. Postoperative pathologic review and immunohistochemical staining with thyroid transcription factor-1 revealed metastatic adenocarcinoma consistent with her lung primary in her uterus and adnexa. Our case represents a rare occurrence in which lung cancer has metastasized to multiple female pelvic organs. Increasing use of PET/CT may lead to the discovery of occult metastases masquerading as a second primary malignancy.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Parini
authors.forename: D
authors.initials: D
authors.lastname: Mathis
authors.forename: C A
authors.initials: CA
authors.lastname: Leath
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D002296:Carcinosarcoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*