Case report

Extrapulmonary small cell sarcinoma: involvement of the brain without evidence of extracranial malignancy by serial PET/CT scans

Christopher N Hueser¹ , Nghi C Nguyen² , Medhat Osman² , Necat Havlioglu³ and Anjali J Patel⁴

¹Department of Internal Medicine, Division of Hematology and Oncology, St. Louis University Hospital, St. Louis, MO 63110, USA

²Department of Nuclear Medicine, St. Louis University Hospital, St. Louis, MO 63110, USA

³Department of Pathology, St. Louis University Hospital, St. Louis, MO 63110, USA

⁴Department of Anesthesia and Critical Care, St. Louis University Hospital, St. Louis, MO 63110, USA

author email corresponding author email

World Journal of Surgical Oncology 2008, 6:102doi:10.1186/1477-7819-6-102

Published:	25 September 2008

Abstract

Background

Extrapulmonary small cell carcinoma (EPSCC) involving the brain is a rare manifestation of an uncommon tumor type.

Case presentation

We report a 59 year-old Caucasian female diagnosed with an EPSCC involving the left parietal lobe without detectable extracranial primary tumor followed by serial positron emission tomography/computed tomography (PET/CT) imaging. Histopathological examination at both initial presentation and recurrence revealed small cell carcinoma. Serial PET/CT scans of the entire body failed to reveal any extracranial [¹⁸F]2-fluoro-2-deoxy-D-glucose (FDG) avid lesions at either diagnosis or follow-up.

Conclusion

Chemotherapy may show a transient response in the treatment of EPSCC. Further studies are needed to help identify optimal treatment strategies. Combination PET/CT technology may be a useful tool to monitor EPSCC and assess for an occult primary malignancy.