title: Unabsorbed polylactide adhesion barrier mimicking recurrence of gynecologic malignant diseases with increased ¹⁸F-FDG uptake on PET/CT.
abstract: OBJECTIVE
  To evaluate the incidence and characteristics of the unabsorbed polylactide adhesion barrier with increased (18)F-fluorodeoxyglucose ((18)F-FDG) uptake after surgeries for gynecologic malignancies.
  
  
  METHODS
  Between September 2006 and November 2009, we reviewed the charts of 75 patients who were provided a polylactide adhesion barrier after surgery for gynecologic malignant diseases. We surveyed the cases of increased (18)F-FDG uptake on positron emission tomography/computed tomography (PET/CT), and evaluated the effectiveness of polylactide adhesion barrier using an adhesion scoring system.
  
  
  RESULTS
  Ten patients (13.3 %) had a solitary pelvic mass with increased (18)F-FDG uptake in the follow up PET/CT. The characteristics of patients and tumors are described below. The median age was 48 years (range 19-66 years). The median tumor size was 1.9 cm (range 1.0-2.3 cm), and the median SUVmax of the pelvic mass was 5.1 (range 3.7-7.9). The median time between initial operations and second operation was 13.5 months (range 8-23 months). We performed laparoscopic excision of the pelvic mass, and the biopsy revealed foreign body reactions with the exception of 1 case, which contained tumor cells under the unabsorbed polylactide adhesion barrier. The median adhesion grade was 1 (range 0-2).
  
  
  CONCLUSIONS
  A solitary pelvic mass found in the PET/CT with increased (18)F-FDG uptake after usage of a polylactide adhesion barrier may be an unabsorbed remnant. The adhesion barrier should be used with caution in patients with gynecologic malignant diseases.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Medical Center, 807 Hogukno, Buk-gu, Daegu, 702-210, Korea.
authors.forename: Gun Oh
authors.initials: GO
authors.lastname: Chong
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Lee
authors.forename: Dae Gy
authors.initials: DG
authors.lastname: Hong
authors.forename: Young Lae
authors.initials: YL
authors.lastname: Cho
authors.forename: Yoon Soon
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011091:Polyesters / Q000737:chemistry*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D011091:Polyesters; D019788:Fluorodeoxyglucose F18; C033616:poly(lactide)