Skip to main content
Log in

Cowden Syndrome Detected by FDG PET/CT in an Endometrial Cancer Patient

  • Case Report
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Cowden syndrome (CS) is a rare autosomal dominant disorder characterized by multiple hamartomas in various tissues and cancers (breast, thyroid, and endometrium). We report CS of the esophagus and gastrointestinal tract that was incidentally detected by positron emission tomography/computed tomography (PET/CT) at postoperative surveillance in an endometrial cancer patient. PET/CT showed mildly increased FDG uptake along the entire esophagus and stomach. Upper GI endoscopy and histologic examination revealed glycogenic acanthosis of the esophagus and several hundred gastric polyps. In our case, increased FDG uptake of the esophageal wall contributed to the diagnosis of CS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Lee EJ, Jung WS, Ko JM, Park HJ. Multiorgan involvements of Cowden disease in a 50-year-old woman: a case report and literature overview. J Korean So Radiol. 2013;69:251–5.

    Article  Google Scholar 

  2. Ha M, Chung JW, Hahm KB, Kim YJ, Lee W, An J, et al. A case of Cowden syndrome diagnosed from multiple gastric polyposis. World J Gastroenterol: WJG. 2012;18:861–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lloyd KM, Dennis M. Cowden’s disease: a possible new symptom complex with multiple system involvement. Ann Intern Med. 1963;58:136–42.

    Article  PubMed  Google Scholar 

  4. Pilarski R, Burt R, Kohlman W, Pho L, Shannon KM, Swisher E. Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst. 2013;105:1607–16.

    Article  CAS  PubMed  Google Scholar 

  5. Saito K, Nomura E, Sasaki Y, Abe Y, Kanno N, Mizumoto N, et al. Characteristics of small bowel polyps detected in cowden syndrome by capsule endoscopy. Case Rep Gastroint Med. 2015. doi:10.1155/2015/475705.

    Google Scholar 

  6. Campos FG, Habr-Gama A, Kiss DR, Atuí FC, Rawet V, Goldstein PJ, et al. Cowden syndrome: report of two cases and review of clinical presentation and management of a rare colorectal polyposis. Curr Surg. 2006;63:15–9.

    Article  PubMed  Google Scholar 

  7. Eng C. Will the real Cowden syndrome please stand up: revised diagnostic criteria. J Med Genet. 2000;37:828–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. McGarrity TJ, Baker MJW, Ruggiero FM, Thiboutot DM, Hampel H, Zhou X-P, et al. GI polyposis and glycogenic acanthosis of the esophagus associated with PTEN mutation positive Cowden syndrome in the absence of cutaneous manifestations. Am J Gastroenterol. 2003;98:1429–34.

    Article  PubMed  Google Scholar 

  9. Makis W, Ciarallo A, Hickeson M. The use of 18F-FDG PET/CT in Cowden syndrome to differentiate multifocal gastric carcinoma from extensive benign gastric polyposis. Clin Nucl Med. 2012;37:311–4.

    Article  PubMed  Google Scholar 

  10. Kamel EM, Thumshirn M, Truninger K, Schiesser M, Fried M, Padberg B, et al. Significance of incidental 18F-FDG accumulations in the gastrointestinal tract in PET/CT: correlation with endoscopic and histopathologic results. J Nucl Med. 2004;45:1804–10.

    PubMed  Google Scholar 

  11. Dong A, Wang Y, Zuo C. FDG PET/CT in eosinophilic esophagitis. Clin Nuclear Med. 2014;39:540–3.

    Article  Google Scholar 

  12. Roedl JB, Colen RR, King K, Fischman AJ, Mueller PR, Blake MA. Visual PET/CT scoring for nonspecific 18F-FDG uptake in the differentiation of early malignant and benign esophageal lesions. Am J Roentgenol. 2008;191:515–21.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Geon Park.

Ethics declarations

Conflict of Interest

Yun Hee Kang, Hye Kyung Lee, and Geon Park declare that they have no conflict of interest.

Ethical Statement

The study was approved by an institutional review board.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, Y.H., Lee, H.K. & Park, G. Cowden Syndrome Detected by FDG PET/CT in an Endometrial Cancer Patient. Nucl Med Mol Imaging 50, 255–257 (2016). https://doi.org/10.1007/s13139-016-0427-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-016-0427-8

Keywords

Navigation