99m Tc-FAPI-46 Scintigraphy in Parotid Mucoepidermoid Carcinoma.
Amin Saber Tanha, Kamran Aryana, Siavash Zahed Anaraki et al.
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Case in brief
A 58-year-old woman with recurrent mucoepidermoid carcinoma of the right parotid gland experienced progressive bone pain after surgery and radiotherapy. Initial bone scintigraphy showed limited skeletal metastases, but palliative treatment was ineffective. A subsequent 99m Tc-FAPI-46 scintigraphy revealed extensive skeletal metastases, pulmonary involvement, and metastatic lymph nodes, indicating a greater disease burden and guiding further management.
What made this case unusual
The case illustrates the superior sensitivity of 99m Tc-FAPI-46 scintigraphy in detecting metastatic disease compared to conventional imaging, particularly in a patient with discordant symptoms.
Diagnostic / clinical pearl
Clinicians should consider FAP-targeted imaging like 99m Tc-FAPI-46 in cases of suspected metastatic mucoepidermoid carcinoma, especially when symptoms and conventional imaging findings are inconsistent.
Why it matters
This case underscores the importance of advanced imaging techniques in accurately assessing disease extent, which can significantly impact treatment decisions in oncology.