Nefrotoksik Kemoterapiye İkincil Böbrek Yetmezliği Gelişen Bir Olguda FDG PET/BT’de Böbrek Bulguları
Abstract
Küçük hücreli akciğer kanseri tanısı almış 60 yaşındaki erkek hasta yeniden evrelenmek üzere FDG PET/BT istemiyle bölümümüze yönlendirildi. Kontrastlı toraks tomografisinde küçük hücreli akciğer kanserinin kitle etkisine bağlı olarak vena kava süperior sendromu geliştiği görülmekteydi. FDG PET/BT’de sağ akciğer üst lobda artmış FDG tutulumu gösteren kitle lezyonu, kemik yapılarda belirgin olmak üzere tüm vücutta metabolik aktivite artışı gösteren lezyonlar, her iki böbrek boyutunda artış ve böbrek parankimlerinde diffüz artmış FDG tutulumu saptandı. Hastanın öyküsünden 450 mg/m2 dozunda karboplatin aldığı, PET/BT çekimi sırasında serum üre ve kreatinin seviyelerinin sırasıyla 81 mg/dl n:17-43 mg/dl ve 1.78 mg/dl n: 0.7-1.2 mg/dl olduğu öğrenildi. Tetkik esnasında günlük idrar miktarı 350cc/gün idi. Hastanın takibinde, serum üre ve kreatinin düzeylerinin 48 mg/dl ve 1.1 mg/dl’ye düştüğü ve günlük idrar miktarının normale döndüğü görüldü. Böbreklerdeki artmış FDG tutulumunun karboplatin toksisitesine ikincil gelişen akut tübüler nekroza bağlı olduğu düşünüldü. Takip sırasında renal fonksiyonların normale dönmesi de bu tezi desteklemekteydi. Bu sunumda küçük hücreli akciğer kanserli bir hastada karboplatin tedavisine bağlı nefrotoksisitenin FDG-PET/BT bulgularını sunuyoruz
References
- Pierre D. Maldjian, Nasrin Ghesani. Focal Increased Activity in the Liver on 18F-FDG PET Scan Secondary to Brachiocephalic Vein and Superior Vena Cava Obstruction. J Thorac Imaging 2008;23:275–277.
- Kintzel PE. Anticancer drug-induced kidney disorders. Drug Saf. 2001;24(1):19-38.
- Sleijfer DT, Smit EF, Meijer S, Mulder NH, Postmus PE. Acute and cumulative effects of carboplatin on renal function. Br J Cancer 1989; 60: 116-120.
- Krishnan SG, VanderBrink B, Weiss G, Singhal PC, Shah HH. Renal pelvic hemorrhage and acute renal failure associated with carboplatin therapy. Urology. 2007;70(6):1222.e5-7.
Abstract
A 60 year old male, diagnosed with small cell lung carcinoma was referred for FDG PET/CT for re-staging to our department. On contrast enhanced computed tomography, the diagnosis was vena cava superior syndrome due to the mass effect of small cell lung carcinoma. On FDG PET/CT imaging, a mass located at right upper lobe with increased FDG uptake, multiple increased metabolic activity foci at several locations in bone, enlargement of both renal size and diffuse increased FDG uptake at both kidneys were seen. Upon questioning the patinet explained he was treated with 450mg/m2 carboplatin 3 weeks ago. At the time of FDG PET/CT scanning, his BUN and creatinin level were 81 mg/dl n: 17-43mg/dl and 1.78mg/dl n: 0.71.2mg/dl , respectively. His urine volume was 350 cc /day during the examination. During follow-up BUN and creatinin level decreased to 48mg/dl and 1.1mg/dl and the volume of the urine was increased to normal level. It was assumed that increased FDG involvement of kidney was caused by acute tubular necrosis due to carboplatin toxicity. Normalization of renal functions and creatinin, BUN and urine volume during follow-up also supportted this thesis. Here, we present FDG PET/CT findings of a case with small cell lung carcinoma and nefrotoxicity due to carboplatin treatment
References
- Pierre D. Maldjian, Nasrin Ghesani. Focal Increased Activity in the Liver on 18F-FDG PET Scan Secondary to Brachiocephalic Vein and Superior Vena Cava Obstruction. J Thorac Imaging 2008;23:275–277.
- Kintzel PE. Anticancer drug-induced kidney disorders. Drug Saf. 2001;24(1):19-38.
- Sleijfer DT, Smit EF, Meijer S, Mulder NH, Postmus PE. Acute and cumulative effects of carboplatin on renal function. Br J Cancer 1989; 60: 116-120.
- Krishnan SG, VanderBrink B, Weiss G, Singhal PC, Shah HH. Renal pelvic hemorrhage and acute renal failure associated with carboplatin therapy. Urology. 2007;70(6):1222.e5-7.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 1, 2011 |
| Published in Issue | Year 2011Issue: 4 |