Advertisement

Archives of Gynecology and Obstetrics

, Volume 280, Issue 1, pp 141–144 | Cite as

Unusual 2-[18F]-fluoro-2-deoxy-d-glucose accumulation induced by postoperative intestinocutaneous fistula in the patient with uterine cervical cancer and SLE

  • Myungsin Kim
  • Myong Cheol Lim
  • Sang Soo Seo
  • Sokbom Kang
  • Seok-Ki Kim
  • Sang-Yoon ParkEmail author
Case Report

Abstract

A 47-year-old woman with systemic lupus erythematosus presented with a history of radical hysterectomy and pelvic lymph node dissection for cervical cancer Ia and brachytherapy for vaginal recurrence. Four years later, abnormal hypermetabolic lesion at vaginal vault on FDG-PET/CT was found and confirmed as vaginal recurrence by punch biopsy. So, she underwent anterior pelvic exenteration with urostomy. She underwent colostomy because of colonic fistula 1 week after anterior pelvic exenteration. She had wound problem near the colostomy site. The wound waxed and waned, however, no definite discharge was identified from wound. Three months later after anterior pelvic exenteration, FDG-PET/CT revealed multiple hypermetabolic lesions along the incision line, colostomy site and abdominopelvic lymph nodes. Biopsies of the skin and lymph nodes with FDG accumulation revealed an inflammatory granulation tissue and reactive lymphadenopathy. Definite symptom such as leakage of stool was not identified. One year later, there was no interval change of multiple hypermetabolic lesions on follow-up FDG-PET/CT. There was still wound problem. So, revision of colostomy was done with impression of subtle fistula between skin and colostomy. Multiple hypermetabolic lesions on FDG-PET/CT disappeared after 3 months of repair of colostomy. We reported a case showing high FDG accumulation at wound and paraaortic lymph node on PET/CT because of intestinocutaneous fistula around colostomy. These malignant mimicking FDG accumulations were disappeared after colostomy reversion.

Keywords

Positron emission tomography Cervical cancer Recurrence SLE Fistula 

Notes

Conflict of interest statement

None.

References

  1. 1.
    Kumar R, Alavi A (2004) PET imaging in gynecologic malignancies. Radiol Clin North Am 42(6):1155–1167. doi: 10.1016/j.rcl.2004.08.006 PubMedCrossRefGoogle Scholar
  2. 2.
    Sugawara Y, Eisbruch A, Kosuda S, Recker BE, Kison PV, Wahl RL (1999) Evaluation of FDG-PET in patients with cervical cancer. J Nucl Med 40:1125–1131PubMedGoogle Scholar
  3. 3.
    Cook GJ (2007) Pitfalls in PET/CT interpretation. Q J Nucl Med Mol Imaging 51(3):235–243PubMedGoogle Scholar
  4. 4.
    Ryu SY, Kim MH, Choi SC, Choi CW, Lee KH (2003) Detection of early recurrence with 18F-FDG PET in patients with cervical cancer. J Nucl Med 44:347–352PubMedGoogle Scholar
  5. 5.
    Juweid ME, Cheson BD (2006) Positron-emission tomography and assessment of cancer therapy. N Engl J Med 354:469–507. doi: 10.1056/NEJMra050276 CrossRefGoogle Scholar
  6. 6.
    Fey GL, Jolles PR, Buckley LM, Massey GV (2004) 2-Deoxy-2-[18F]fluoro-d-glucose positron emission tomography uptake in systemic lupus erythematosus-associated adenopathy. Mol Imaging Biol 6(1):7–11. doi: 10.1016/j.mibio.2003.12.003 PubMedCrossRefGoogle Scholar
  7. 7.
    Lucignani G, Paganelli G, Bombardieri E (2004) The use of standardized uptake values for assessing DFG uptake with PET in oncology: a clinical perspective. Nucl Med Commun 25(7):651–656. doi: 10.1097/01.mnm.0000134329.30912.49 PubMedCrossRefGoogle Scholar
  8. 8.
    Shreve PD (1998) Focal fluorine-18 fluorodeoxyglucose accumulation in inflammatory pancreatic disease. Eur J Nucl Med 25:259. doi: 10.1007/s002590050226 PubMedCrossRefGoogle Scholar
  9. 9.
    Nowak M, Carrasquillo JA, Yarboro CH et al (2004) A pilot study of the use of 2-[18F]-fluoro-2-deoxy-d-glucose-positron emission tomography to assess the distribution of activated lymphocytes in patients with systemic lupus erythematosus. Arthritis Rheum 50(4):1233–1238. doi: 10.1002/art.20150 PubMedCrossRefGoogle Scholar
  10. 10.
    Salkov A, Tammisetti VS, Grierson J, Vesselle H (2007) FLT: measuring tumor cell proliferation in vivo with positron emission tomography and 3′-deoxy-3′-[18F] fluorothymidine. Semin Nucl Med 37(6):429–439. doi: 10.1053/j.semnuclmed.2007.08.001 CrossRefGoogle Scholar
  11. 11.
    Zhao S, Kuge Y, Kohanawa M, Takahashi T, Zhao Y, Yi M et al (2008) Usefulness of [11C]-methionine for differentiating tumors from granulomas in experimental rat models: a comparison with 18F-FDG and 18F-FLT. J Nucl Med 49(1):135–141. doi: 10.2967/jnumed.107.044578 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Myungsin Kim
    • 1
  • Myong Cheol Lim
    • 3
  • Sang Soo Seo
    • 3
  • Sokbom Kang
    • 3
  • Seok-Ki Kim
    • 2
  • Sang-Yoon Park
    • 3
    Email author
  1. 1.Department of Obstetrics and Gynecology, College of MedicineSeoul National UniversitySeoulSouth Korea
  2. 2.Department of Nuclear Medicine, Research Institute and HospitalNational Cancer CenterGoyangSouth Korea
  3. 3.Centre of Uterine Cancer, Research Institute and HospitalNational Cancer CenterGoyangSouth Korea

Personalised recommendations