Advertisement

Unusual FDG PET/CT Uptake in Uterine Tumors in Cancer Survivor

  • Ujwala PrakashEmail author
  • R. Krishnakumar
  • K. M. Lakshmipathy
  • Easwaramoorthy Venkatachalapathy
Case Report
  • 14 Downloads

Abstract

Introduction

18-Fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT) has become the essential modality of imaging in diagnosis; it is used for assessment of treatment response, after chemotherapy, as well as for prognostic evaluation. Case 1 is a postmenopausal woman treated for the case of Langerhans cell sarcoma; she received chemotherapy; post-chemotherapy PET/CT scan was done to assess the response to chemotherapy with an SUV of 7.1 in the uterus. The rest of the report showed no uptake elsewhere in the body, and hysterectomy with BSO pathological report showed benign leiomyoma. Case 2 is treated for carcinoma thyroid by surgery and radioiodine ablation therapy. She was on regular follow-up, and she is a premenopausal multiparous woman with regular menstruation and on annual PET/CT examination incidentally showed an increased SUV of 8 in the uterus. There was no FDG uptake elsewhere in the body except for uterus.

Conclusion

False-positive uptake of 18-FDG PET/CT in uterine tumors can be seen in leiomyoma which has high SUV of more than 6. Surgical management with histopathological confirmation of leiomyoma is needed in cases treated for malignancy elsewhere in the body; we report these two cases hoping to expand the existing knowledge on the topic and highlight the limitation of PET/CT in the diagnosis of leiomyoma.

Keywords

Leiomyoma PET/CT uptake Malignancy 

Abbreviations

18F-FDG

18F-fluoro-2-deoxyglucose

PET/CT

Positron emission tomography/computed tomography

BSO

Bilateral salpingo-oophorectomy

Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that there is no conflict of interest and financial interest.

References

  1. 1.
    Kitajima K, Murakami K, Kaji Y, Sugimura K. Spectrum of FDG PET/CT findings of uterine tumors. AJR Am J Roentgenol. 2010;195(3):737–43.CrossRefGoogle Scholar
  2. 2.
    Ma Y, Shao X. Uterine fibroids with positive 18F-FDG PET/CT image and significantly increased CA19-9: a case report. Medicine. 2017;96(51):e9421.CrossRefGoogle Scholar
  3. 3.
    Jin X, Meng Y, Zhu Z, Jing H, Li F. Elevated 99mTc 3PRGD2 activity in benign metastasizing leiomyoma. Clin Nucl Med. 2013;38(2):117–9.CrossRefGoogle Scholar
  4. 4.
    Sawai Y, Shimizu T, Yamanaka Y, Niki M, Nomura S. Benign metastasizing leiomyoma and 18-FDG-PET/CT: a case report and literature review. Oncol Lett. 2017;14(3):3641–6.CrossRefGoogle Scholar
  5. 5.
    di Scioscio V, Feraco P, Miglio L, Toni F, Malvi D, Pacilli AM, et al. Benign metastasizing leiomyoma of the lung: PET findings. J Thorac Imaging. 2009;24(1):41–4.CrossRefGoogle Scholar
  6. 6.
    Tsukada H, Murakami M, Shida M, Kikuchi K, Watanabe M, Yasuda S, et al. 18F-fluorodeoxyglucose uptake in uterine leiomyomas in healthy women. Clin Imaging. 2009;33(6):462–7.CrossRefGoogle Scholar
  7. 7.
    Hofman MS, Hicks RJ. How we read oncologic FDG PET/CT. Cancer Imaging Off Publ Int Cancer Imaging Soc. 2016;16(1):35.Google Scholar
  8. 8.
    Vriens D, de Geus-Oei LF, Flucke UE, van der Kogel AJ, Oyen WJ, Vierhout ME, et al. Benign uterine uptake of FDG: a case report and review of literature. Neth J Med. 2010;68(9):379–80.PubMedGoogle Scholar
  9. 9.
    Nonoyama K, Kitagami H, Yasuda A, Fujihata S, Yamamoto M, Shimizu Y, et al. A giant duodenal leiomyoma showing increased uptake on 18F-Fluorodeoxyglucose positron emission tomography. Case Rep Surg. 2018;2018:7827163.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Da Sun GW, Chen W, Chen J-Y, Zhong J. A study of uterine leiomyoma with FDG PET-CT. J Nucl Med. 2015;56(5):5.Google Scholar
  11. 11.
    Stangierski A, Wolinski K, Czepczynski R, Czarnywojtek A, Lodyga M, Wyszomirska A, et al. The usefulness of standardized uptake value in differentiation between benign and malignant thyroid lesions detected incidentally in 18F-FDG PET/CT examination. PloS One. 2014;9(10):e109612.CrossRefGoogle Scholar
  12. 12.
    Chun K-A. Case reports on the differentiation of malignant and benign intratracheal lesions by 18F-FDG PET/CT. Medicine. 2015;94(44):e1704.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Ujwala Prakash
    • 1
    Email author
  • R. Krishnakumar
    • 2
  • K. M. Lakshmipathy
    • 3
  • Easwaramoorthy Venkatachalapathy
    • 4
  1. 1.Department of Surgical OncologyCancer Institute WIA- AdyarChennaiIndia
  2. 2.Cancer Institute WIA-AdyarChennaiIndia
  3. 3.HCG CentreChennaiIndia
  4. 4.SRMCPorur, ChennaiIndia

Personalised recommendations