Falsely Upstaged Breast Cancer by F-2-Fluoro-2-Deoxy-D- Glucose Positron Emission Tomography in a Patient with Concomitant Pulmonary Tuberculosis

Received 10/12/2006; revised 11/15/2006; accepted 11/16/2006. For correspondence or reprints contact: Shin-Cheh Chen, M.D., Department of General Surgery, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kueishan, Taoyuan 333, Taiwan. Tel: (886)3-3281200 ext. 2620, Fax: (886)3-2110052, E-mail: [email protected] Immunocompromised patients undergoing long-term steroid therapy may be afflicted with opportunistic infections such as pyogenic bacteria, Listeria, fungi, legionellosis, herpes viruses, and tuberculosis. For cancer patients with concomitant opportunistic infections, F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) may not able to clearly distinguish benign lesions from malignant. Herein, we report a case that was falsely upstaged as lung metastases by FDG PET. A pre-operative CT-guided biopsy was performed, which identified the patient as suffering from breast cancer with concomitant pulmonary tuberculosis.