INTRODUCTION: F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/ computed tomography (CT) imaging is often used in the surveillance of recurrent colorectal cancers after curative resections. We report 2 patients where FDG combined PET/CT imaging produced false positive results due to chronic inflammation and suture granuloma. CLINICAL PICTURE: Case 1 is a patient with a curative anterior resection done 10 months ago. Serial surveillance carcinoembryonic antigen (CEA) showed a marginal elevation. A solitary "hot spot" on combined PET/CT imaging was seen at the level of the previously resected inferior mesenteric vein. Case 2 is a patient with a positive solitary lesion on combined PET/CT imaging 16 months after a curative right hemicolectomy for colorectal cancer. The serum CEA was within normal limits. TREATMENT: Both patients had undergone exploratory laparotomy with complete resection of the solitary lesions. OUTCOME: The histology of Case 1 was reported as a suture granuloma while the histology of Case 2 was reported as an inflammatory nodule related to the previous suture pedicle, both with no malignant tissues identified. CONCLUSIONS: False positives on combined PET/CT imaging may result from inflammatory granulomas months after surgery.
INTRODUCTION: F-18 fluorodeoxyglucose (FDG) combined positron emission tomography (PET)/ computed tomography (CT) imaging is often used in the surveillance of recurrent colorectal cancers after curative resections. We report 2 patients where FDG combined PET/CT imaging produced false positive results due to chronic inflammation and suture granuloma. CLINICAL PICTURE: Case 1 is a patient with a curative anterior resection done 10 months ago. Serial surveillance carcinoembryonic antigen (CEA) showed a marginal elevation. A solitary "hot spot" on combined PET/CT imaging was seen at the level of the previously resected inferior mesenteric vein. Case 2 is a patient with a positive solitary lesion on combined PET/CT imaging 16 months after a curative right hemicolectomy for colorectal cancer. The serum CEA was within normal limits. TREATMENT: Both patients had undergone exploratory laparotomy with complete resection of the solitary lesions. OUTCOME: The histology of Case 1 was reported as a suture granuloma while the histology of Case 2 was reported as an inflammatory nodule related to the previous suture pedicle, both with no malignant tissues identified. CONCLUSIONS: False positives on combined PET/CT imaging may result from inflammatory granulomas months after surgery.
Authors: Ubaldo E Martinez-Outschoorn; Stephanos Pavlides; Anthony Howell; Richard G Pestell; Herbert B Tanowitz; Federica Sotgia; Michael P Lisanti Journal: Int J Biochem Cell Biol Date: 2011-02-15 Impact factor: 5.085
Authors: Ludovica Imperiale; Claudia Marchetti; Laura Salerno; Roberta Iadarola; Carlotta Bracchi; Laura Vertechy; Lucia di Francesco; Angela Musella; Elisa Bevilacqua; Primo Pennesi; Innocenza Palaia; Pierluigi Benedetti Panici Journal: J Med Case Rep Date: 2014-06-18