FDG PET/CT Appearance of Tumor Thrombus of Ovarian Vessels Masquerading as Retroperitoneal Fibrosis

Abstract

A 23-year-old woman with recurrent uterine endometrial stromal sarcoma underwent FDG PET/CT, which showed pelvic recurrence and multiple pulmonary metastases. In addition, increased activity in a vertical soft tissue mass along the left ureter was noted, which appears similar to retroperitoneal fibrosis on PET/CT images. However, pathological examination demonstrated that the elevated FDG activity in this mass was a result of tumor thrombus from endometrial stromal sarcoma in the left ovarian arteries and veins.

Intravenous low-grade endometrial stromal sarcoma with intracardiac extension: A CASE OF inaccurate tumor location on contrast-enhanced computed tomography

“…18-Fluorodeoxyglucose (FDG) positron emission tomography-CT (PET-CT) may also be a viable choice for determining the tumor location or distinguishing between sarcoma and benign leiomyoma. PET-CT has been reported as an effective tool for the detection of uterine sarcoma metastasis (21), but reports are limited for LG-ESS (22,23). Certain tumors and metastatic lesions are known to exhibit a low FDG uptake (24) and its accuracy for intravascular lesions is unreported to date; thus, even if performed preoperatively, tumors in the IVC above the level of the renal veins may not be detected.…”

Rare case of an ovarian vein tumor thrombosis identified on fluorodeoxyglucose positron emission tomography/computed tomography

“…[ 4 ] Identification of OVT on FDG PET/CT to our knowledge has been reported only once in literature. [ 8 ] This case re-illustrates the potential clinical utility of PET/CT in imaging tumor thrombus.…”