Endometriosis with FDG uptake on PET.
BACKGROUND
The value of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in endometriosis has not yet been extensively reported.


METHODS
A 32-year-old woman was examined to find an explanation for right pelvic pain associated with right subcostal pain. A computerised tomography (CT) scan was compatible with a haemangioma or a focus of endometriosis in the liver. Transvaginal sonography and magnetic resonance imaging (MRI) showed a complex ovarian cyst on the left. Blood CA125 levels were elevated. FDG-PET revealed a focus of uptake in the right paravesical area. Laparoscopy showed a left endometrioma associated with diffuse inflammatory pelvic adhesions. After surgery and 3 months GnRH agonist treatment the pain had disappeared and neither MRI nor FDG-PET showed any pelvic abnormality. The patient subsequently presented with dyspareunia and rectal pain resulting from a right uterosacral nodule and a rectal nodule. These were resected laparoscopically. After a 1-year follow-up, the patient is doing well.


CONCLUSIONS
Endometriosis can give rise to false-positive results on FDG-PET. However, the FDG uptake in this particular case of endometriosis seems to have been due to inflammation rather than to a cyst. This report highlights the relationship between some of the biological features of endometriosis and some observed in neoplastic lesions.
Jeffry
Louis
L
Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.
Kerrou
Khaldoun
K
Camatte
Sophie
S
Metzger
Ulrike
U
Lelièvre
Loic
L
Talbot
Jean-Noel
JN
Lecuru
Fabrice
F
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D019160:Endosonography; D005260:Female; D019788:Fluorodeoxyglucose F18; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D017699:Pelvic Pain; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012008:Recurrence; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D018394:CA-125 Antigen; D006728:Hormones; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007987:Gonadotropin-Releasing Hormone