John Seto

Left maxillary sinus malignant fibrous histiocytoma on FDG PET-CT.

We report the PET-CT appearance of a newly diagnosed malignant fibrous histiocytoma, involving the left maxillary sinus with pulmonary metastases, in a 69-year-old man. Initial staging PET-CT images demonstrated a large, intensely hypermetabolic mass involving the entire left maxillary sinus, consistent with the primary tumor. In addition, there were several hypermetabolic pulmonary nodules bilaterally, most consistent with pulmonary metastases. Malignant fibrous histiocytoma is a high-grade and aggressive sarcoma and relatively rare in the head and neck region, and very rare in the maxillary sinus. The main management includes surgical resection with or without postoperative chemoradiation therapy.

FDG PET/CT imaging in granulomatous changes secondary to breast silicone injection.

An 81-year-old woman with history of silicone injection and saline bag implants in both breasts was diagnosed over 30 years later with lobular carcinoma in her right breast and underwent right mastectomy. She was referred to our institution for a restaging PET-CT examination. The PET-CT images showed multiple lobulated/nodular, hypermetabolic, soft-tissue masses, and scattered calcifications involving the right chest wall, left breast, and bilateral axillary regions. Biopsy was consistent with silicone-related granulomatous tissue. The largest soft-tissue mass in the

Renal metastasis from primary colon cancer on FDG PET-CT.

We report the PET-CT appearance of a metastasis from a primary colon cancer to the right kidney in an 84-year-old woman with a history of moderately differentiated adenocarcinoma of the cecum. The patient underwent right hemicolectomy and chemotherapy. Restaging PET-CT study, 4 months after her last chemotherapy, demonstrates a hypermetabolic soft-tissue mass in the inferior pole of the right kidney. The patient subsequently had a right partial nephrectomy. The pathology was consistent with metastatic colonic adenocarcinoma. Renal metastasis from primary colon cancer is very rare.

Intramuscular metastasis of endometrial carcinoma on FDG PET/CT.

We report the F-18 FDG PET/CT appearance of biopsy proven intramuscular metastasis from primary endometrial carcinoma. The patient is a 70-year-old woman initially diagnosed with endometrioid adenocarcinoma, status post total abdominal hysterectomy, bilateral salpingo-oopherectomy and pelvic node dissection. Restaging PET/CT study performed 1 year later demonstrated extensive metastatic disease involving the intramuscular region of the right neck, right kidney, pancreas, left adrenal gland, lungs, lymph nodes, and bone. The lesion in the right neck intramuscular region was subsequently biopsied and interpreted as consistent with metastasis from an endometrial primary. Metastasis to the skeletal muscle from the primary endometrial carcinoma is a rare entity. Knowledge of this rare metastatic site will help the interpreting physician make the correct diagnosis.

F-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in left thigh intramuscular myxoma.

We report F-18 FDG PET-CT appearance of biopsy-proven intramuscular myxoma (IM) in a 69-year-old woman who presented with a left thigh mass. The tumor appears as a well-defined, hypodense mass with thin septation on CT images and mild uptake on PET images. IMs are rare benign myxoid tumors characterized by a paucity of cells, diminished vascularity, and minimal mitotic figures. They most often present as slow-growing, painless, deep-seated intramuscular masses. The mainstay of treatment is surgical resection.

Multi-level lumbar Baastrup disease on F-18 FDG PET-CT.

Abstract:We report the positron emission tomography-computed tomography appearance of Baastrup disease in the L2–L5 interspinous ligament region in a 79-year-old woman with a history of moderately differentiated lobular breast carcinoma. The patient is status post bilateral mastectomies, on tamoxife

Recurrent adult Wilms tumor with extensive metastases on FDG PET-CT.

Abstract: We report the PET-CT appearance of recurrent Wilms tumor in the surgical bed with multiple metastatic sites in a 30-year-old man. He was initially diagnosed with Wilms tumor in the right kidney with involvement of the right adrenal gland and right renal vein into the inferior vena cava, for which he underwent a right nephrectomy, right adrenalectomy, and retroperitoneal lymph node dissection. Three months later, a restaging PET-CT study demonstrated multiple hypermetabolic lesions in the surgical bed region, the left adrenal gland, liver, thoracolumbar spine, retroperitoneal lymph nodes, and peritoneum.

Cosmetic-related Changes on 18f-fdg Pet/ct

We present 4 cases of cosmetic-related changes on 18F-FDG PET/CT. These cases represent post-treatment changes from facial juvederm injection, silicone injection in the chest wall and gluteal areas, paraffin injection in the gluteal region, and liposuction. Recognition of cosmetic-related changes and their appearance on PET and CT will help to avoid potential false-positive interpretations.

Extraosseous myxoid chondrosarcoma with pulmonary and nodal metastases on FDG PET-CT.

We report the PET-CT appearance of extraosseous myxoid chondrosarcoma in the left gluteus maximus muscle with diffuse pulmonary and nodal metastases in a 65-year-old man who presented with a large left gluteal mass. Pretherapeutic tumor SUV obtained by FDG PET imaging has been reported as a useful parameter for tumor grading and prediction of outcome in chondrosarcoma patients. In addition, the combination of SUV and histopathologic tumor grade further improves prediction of outcome substantially, allowing identification of patients at high risk for local relapse or metastatic disease.

F-18 FDG PET-CT imaging in recurrent cerebral gliosarcoma.

We report the F-18 FDG PET-CT appearance of recurrent gliosarcoma (GS) with extracranial extension in a 47-year-old man who underwent surgical resection of a right frontal GS 5 months earlier. F-18 FDG PET demonstrated moderate uptake in the recurrent disease. GS is a very rare, biphasic primary neoplasm of the central nervous system, composed of glioblastoma multiforme mixed with a sarcomatous component. It occurs in adults of middle age and carries a poor prognosis. The median survival reported is less than a year. The results suggest that F-18 FDG PET imaging may be useful in detecting recurrent GS.