Contrast‐enhanced ultrasound of polyp malignant transformation with multiple metastases in a patient with Peutz‐Jeghers syndrome

• Published in: Journal of clinical ultrasound 2024-06, Vol.52 (5), p.649-652
• Main Authors: Wang, Xiangyu, Zhang, Longfang, Qiao, Huilian, Liu, Xi, Fan, Xiaozhou
• Format: Article
• Language: English
• Subjects: Adult; Biopsy; Contrast Media; contrast‐enhanced ultrasound; Gastrointestinal system; Gastrointestinal tract; Humans; Image Enhancement - methods; Intestinal Polyps - diagnostic imaging; Intestinal Polyps - surgery; Liver; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Male; Malignancy; malignant transformation; Medical imaging; Metastases; Patients; Peutz-Jeghers Syndrome - complications; Peutz-Jeghers Syndrome - diagnostic imaging; Peutz‐Jeghers syndrome; Phospholipids; Polyps; Small intestine; Sulfur; Sulfur Hexafluoride; Ultrasonography - methods; Ultrasound
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.23677

Multi‐systemic metastasis in patients with Peutz‐Jeghers syndrome (PJS) is very rare, and there are nearly no relevant imaging reports, especially in contrast‐enhanced ultrasound (CEUS). We present here a 40‐year‐old male patient who underwent several partial small bowel resections and endoscopic polypectomy for intestinal polyps. After reviewing the patient's clinical diagnosis and treatment process, CEUS with sulfur hexafluoride microbubbles (SonoVue, Bracco, Milan, Italy) in the liver and gastrointestinal tract was performed. We imaged multiple abnormal masses with sonographic features consistent with malignancies. Combined with other imaging examinations and 18 gauge core‐needle puncture biopsy of liver masses, multiple metastases outside the gastrointestinal tract were considered. This case report suggests CEUS may be an easy, effective, and supplementary method for evaluating PJS patients with suspected multi‐systemic malignant lesions including the gastrointestinal tract. Contrast‐enhanced ultrasound of the liver and small intestine was performed in a 40‐year‐old male patient with Peutz‐Jeghers syndrome. Here we presented the ultrasound typical findings of liver metastasis and possibly malignant polyp in small intestine.