Positron emission tomography with 2-deoxy-2-[18f] fluoro-D-glucose in the detection of malignancy in intraductal papillary mucinous neoplasms of the pancreas.
A 79-year-old Indian male was admitted with upper abdominal discomfort of 1-year duration which was associated with loss of weight and appetite. Serum tumor markers, including carcinoembryonic antigen and carbohydrate antigen 19-9, were within normal limits. A computed tomographic scan demonstrated a cystically dilated and tortuous pancreatic duct measuring 1.9 cm, suggestive of an intraductal papillary mucinous neoplasm. Fusion positron emission tomography/computed tomography with 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography (FDG-PET/CT) which was subsequently performed confirmed a metabolically active focus within the pancreatic head mass with a standard uptake value (SUVmax) of 3.5 compatible with carcinoma. A total pancreatectomy was performed and the final histology demonstrated a main-duct type intraductal papillary mucinous neoplasm with a focus of high-grade dysplasia compatible with carcinoma-in-situ. These images illustrate the emerging utility of FDG-PET/CT in the preoperative detection of malignancy in intraductal papillary mucinous neoplasm.
Goh
Brian K P
BK
Departments of Surgery, Nuclear Medicine, and Pathology, Singapore General Hospital. Singapore, Singapore. bsgkp@hotmail.com.
Chung
Yaw-Fui Alexander
YF
Ng
David C E
DC
Selvarajan
Sathiyamoorthy
S
Soo
Khee-Chee
KC
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis*; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18