Metastasis detection with 18 FDG-positron emission tomography/computed tomography in gestational trophoblastic neoplasia: a report of 2 cases.
BACKGROUND
The imaging methods proposed by the International Consensus for the Diagnosis of Metastases in Trophoblastic Neoplasia are sufficient to stage the disease in most cases. However, there are 2 circumstances in which a more accurate imaging method is necessary: condemonstrate tl fusing images in conventional studies and persistent low 18 FDG-PET/CT human chorionic gonadotropin (hCG) values. Eighteen-fluoro-2-deoxyglucose-positron emission tomography/ computed tomography (18 FDG-PET/CT) can be helpful in these cases.


METHODS
Case 1. A 51-year-old woman was referred to the Hospital Universitario de Caracas from another hospital with a diagnosis of cervical adenosquamous carcinoma. She complained of vaginal bleeding; clinical and sonographic evaluation demonstrated a tumor in the uterus and lower third of the vagina. A new histopathologic study was performed, and choriocarcinoma (CC) was diagnosed and staged as International Federation of Gynecologists and Obstetricians (FIGO) II:12 The im aging studies were confusing, so an 18 FDG-PET/CT was performed, showing multiple nodules in the lungs. Case 2. A 25-year-old woman was admitted with symptoms that mimicked those of ectopic pregnancy; a left salpingectomy was performed, with a histopathologic report of CC. It was classified as FIGO stage 11:4. Treatment consisted of chemotherapy, hysterectomy and 1 pelvic tumor resection. Two years after discontinuing therapy, persistent low hCG values were detected without evident metastatic disease demonstrated by CT. Eighteen FDG-PET/CT showed multiple pulmonary nodules.


CONCLUSIONS
Eighteen FDG-PET/CT seems to reveal metastases that are either confusing or not detected by other imaging techniques currently accepted in most gestational trophoblastic neoplasia protocols.
Cortés-Charry
Rafael
R
Obstetrics and Gynecology Department, Hospital Universitario de Caracas, Universidad Central de Venezuela, and Centro Diagnóstico Docente, Caracas, Venezuela. rafacort083@cantv.net
Figueira
Lina M
LM
Nieves
Luis
L
Colmenter
Luis
L
D000328:Adult; D031954:Choriocarcinoma, Non-gestational / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D031901:Gestational Trophoblastic Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011247:Pregnancy; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18