Complementary roles of immunoscintigraphy and ultrasonography.

A female patient raised the problem of detection of a primary tumor after discovery of multiple nodular, apparently metastatic, lung densifications. Immunoscintigraphy using an anti-CEA antibody revealed two hot spots above and to the right of the urinary bladder. Ultrasonography showed a right ovarian cyst and normal echo texture for the uterus. Surgery confirmed the diagnosis of a right ovarian cyst with a macroscopically normal uterus. Pathological examination demonstrated adenoacanthomatous involvement of the walls of the ovarian cyst and of the uterus. The results of immunoscintigraphy were thus determinant in visualizing the expression of CEA by the ovarian cyst and by the uterus and thus in suggesting their malignancy.