FDG Hepatic Superscan Due to Metastatic Infiltration of Prostate Cancer

Abstract

A 69-year-old man with prostate cancer presented to the hospital with 2 weeks’ history of fever, abdominal distension, and fatigue. Laboratory findings showed signs of acute liver failure, and marked elevation of lactate dehydrogenase and tumor marker levels. Abdominal CT showed hepatomegaly with multiple hypodense lesions in both lobes, suggesting metastases. FDG PET/CT scan shows hypermetabolism unusually in the liver with significantly suppressed heart and brain activity, reminiscent of an FDG hepatic superscan. The hypermetabolic lesions confirmed with Tru-Cut needle biopsy of the liver as metastasis of prostate cancer.

Hepatic Superscan in Methotrexate-Associated Lymphoproliferative Disorder

“…2 Patterns of hepatic superscan were reported previously in leukemia, lymphoma, and metastasis of nasopharyngeal cancer, breast cancer, prostate cancer, or melanoma. [4][5][6][7][8][9][10][11] To my understanding, diffuse hepatic uptake of FDG (hepatic superscan) in MTX-LPD has not been described before.…”

“Hepatic Superscan” Revealed on 18F-FDG PET Due to Drug-Induced Fulminant Hepatitis

“…Superscan was defined as surprisingly high and diffuse activity accumulation in the certain organs such as the skeletal, 4,5 liver, 4 muscle/soft tissues, 6 peritoneum, 7 and kidneys 8 in various nuclear medicine studies. Hepatic superscan could be seen on the 18 F-FDG PET due to multiple neoplastic (primary tumors, 9,10 diffuse metastases, 11,12 and leukemia/lymphoma involvement 13–16 ) and nonneoplastic (tuberculosis, 17,18 infection, 19,20 hepatitis, 21 amyloidosis, 22 porphyria, 19 and hemochromatosis 23 ) etiologies. Notably, elevated FDG accumulation caused by drug-induced hepatitis had been described previously 24,25 .…”