Correlation of Maximum Standardized Uptake Values in 18F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography Scan with Immunohistochemistry and Other Prognostic Factors in Breast Cancer.

OBJECTIVES: The objective of this study was to correlate maximum standardized uptake value (SUVmax) with different immunohistochemical subtypes of breast cancer and other prognostic factors in breast cancer. SUBJECTS AND METHODS: This was a retrospective study including 219 consecutive patients undergoing whole-body fluorodeoxyglucose positron emission tomography/computed tomography scan for the staging of breast cancer. Out of 219 patients, two were male and 217 were female; age ranged from 26 to 85 years with mean age of 54 years. On histopathological examination (HPE), 197 patients were of invasive ductal carcinoma type and two of lobular type. Histopathological grades, immunohistochemistry (IHC) types, and ki-67 values were compared with SUVmax values. RESULTS: The mean SUVmax of the population was 11.39 (±6.05). The mean SUVmax in different HPE grades was Grade 1 = 6.81 ± 5.6, Grade 2 = 11.4 ± 6.12, and Grade 3 = 13.14 ± 5. The mean SUVmax values in different IHC types were Luminal A = 7.75 ± 4.2, Luminal B = 10.01 ± 5.3, triple negative = 15.26 ± 5.6, and HER2 enriched = 11.27 ± 5.2. The mean SUVmax in high ki-67 patients was 11.97 ± 5.85 compared with 7.25 ± 3.43 patients with low ki-67. Univariate analysis showed significant difference in SUVmax in patients with different grades (P = 0.013), hormone receptor positivity (P ≤ 0.001), ki-67 (P < 0.001), and axillary lymph node positivity (P ≤ 0.001). In multivariate regression analysis, there was significantly higher SUVmax value in triple-negative patients after correcting for tumor size, ki-67 value, axillary lymph node status, and grade of tumor. CONCLUSION: High SUVmax values were noted in high-grade, high ki-67, triple-negative, and axillary lymph node positive tumors.

Torsion Ovary, an Unusual Presentation of Carcinoma Appendix Detected in Whole-Body F-18 2-Fluoro 2-deoxy Glucose Positron Emission Tomography/Computed Tomography Scan.

Torsion ovary is one of the common emergencies in gynecology requiring surgery. Torsion ovary is generally caused by cystic lesions of ovary and benign tumors. Malignant tumors rarely present as torsion ovary. Krukenberg tumor presenting as torsion ovary is very rare with only a few case reports described in literature. Stomach is the most common primary site (70%) followed by colorectal, breast, lung, contralateral ovary, pancreatic, cholangiocarcinoma, and gallbladder carcinomas. Krukenberg tumor with primary in appendix is relatively rare. Here, we are presenting an unusual case of mucinous carcinoma appendix with Krukenberg tumor presenting as unilateral torsion ovary, demonstrating the role of whole-body F18 2-Fluoro 2-deoxyglucose positron emission tomography/computed tomography scan in identifying the primary.