Visceral Hepatic Leishmaniasis in a Melanoma Patient in FDG-PET

Abstract

Background: Leishmaniasis is caused by protozoans that depend on female phlebotomine sandflies as vectors. The natural habitat of these sandflies is changing due to climate change. More patients will get immunocompromised due to cancer therapy. Case report: We report the case of a 72-year-old patient with melanoma in whom we found visceral leishmaniasis mimicking hepatic metastasis in routine FDG-PET/CT. The patient was hospitalized due to fever and pancytopenia in the general hospital Steyr. The diagnosis was made by biopsy of the iliac crest with cytological study and polymerase chain reaction. After treatment with amphotericin B, the patient recovered, and tests became negative, including FDG-PET/CT. Because of climate change and the increasing use of immunomodulatory medication, our awareness of such findings should grow. Conclusion: New pitfalls in diagnosis and surveillance of cancer patients because of altered environmental conditions and immunocompromised patients have to be considered.