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Hepatische Filiae bei CUP („cancer of unknown primary“) und schmerzhafter Amaurose

Hepatic metastases in CUP (cancer of unknown primary) and painful amaurosis

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Zusammenfassung

Eine 63-jährige Patientin stellte sich mit seit 9 Monaten bestehender linksseitiger schmerzhafter Amaurose bei V.a. Hämophthalmus vor. Sie wurde bereits bei histologisch gesicherten Lebermetastasen chemotherapeutisch gegen ein Melanom behandelt. Die Lokalisation des Primärtumors war unbekannt. Das initiierte Ganzkörperstaging mittels FDG- (F-18-Fluorodeoxyglukose-)PET/CT ergab als Primarius einen malignomtypischen Prozess im Bereich des linken Bulbus. Nach erfolgter Enukleation bestätigte sich ein primäres Aderhautmelanom, das den serologischen Marker MIA („melanoma inhibitory activity“) vermehrt exprimierte. Durch die FDG-PET/CT konnten die hepatischen Filiae bei CUP und der Lokalbefund in Einklang gebracht und die korrekte Diagnose gestellt werden.

Abstract

A 63-year-old woman presented with a 9-month history of painful amaurosis of the left eye caused by hemophthalmos. She was already undergoing chemotherapy for histopathologically proven liver metastases caused by an assumed melanoma. The location of the primary tumor was unknown. Whole-body FDG-PET/CT staging identified a lesion with characteristically malignant uptake in the region of the left eye as the primary tumor. After enucleation, a primary uveal melanoma was verified that expressed the serological marker melanoma inhibitory activity (MIA). FDG-PET/CT was able to successfully align hepatic metastases due to CUP with local ophthalmologic diagnostic findings and led to a correct diagnosis.

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Authors and Affiliations

  1. Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstraße 8, 80336, München, Deutschland

    A. Klingenstein, M.M. Nentwich, E.M. Messmer & U.C. Schaller

  2. Klinik für Nuklearmedizin, Ludwig-Maximilians-Universität München, München, Deutschland

    A.R. Haug

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  1. A. Klingenstein
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  2. A.R. Haug
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  3. M.M. Nentwich
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  4. E.M. Messmer
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  5. U.C. Schaller
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Correspondence to A. Klingenstein.

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Klingenstein, A., Haug, A., Nentwich, M. et al. Hepatische Filiae bei CUP („cancer of unknown primary“) und schmerzhafter Amaurose. Ophthalmologe 107, 947–950 (2010). https://doi.org/10.1007/s00347-010-2131-x

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  • DOI: https://doi.org/10.1007/s00347-010-2131-x

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