title: Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: (18)F-FDG PET/CT findings.
abstract: A 30-year-old female presented with a 3-month history of erosive stomatitis and bullous lesions, along with recurrent episodes of abdominal pain. She was found to have a retroperitoneal lump in left lumbar region. Skin biopsy revealed bullous disorder. CT guided biopsy of the retroperitoneal mass was suggestive of inflammatory myofibroblastic tumor (IMT). She was started on oral steroids and supportive care, and surgery was being planned when she developed respiratory failure. CT chest revealed vertebral metastases. PET/CT for whole body work up revealed a left para-aortic mass along with multiple skeletal metastases. The patient was kept on conservative management. After 3 months, the patient has shown clinical improvement, and an exploratory laparotomy is now being planned for the excision of the tumor, followed by chemotherapy. This case of retroperitoneal IMT is rare in terms of skeletal metastases with paraneoplastic pemphigus.
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: V S
authors.initials: VS
authors.lastname: Dhull
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: A
authors.initials: A
authors.lastname: Passah
authors.affiliation: Department of Radiodiagnosis, M S Ramaiah Medical College, Bengaluru, India.
authors.forename: N
authors.initials: N
authors.lastname: Rana
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Mallick
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. Electronic address: rkphulia@yahoo.com.
authors.forename: R
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006104:Granuloma, Plasma Cell / Q000000981:diagnostic imaging*; D006801:Humans; D010257:Paraneoplastic Syndromes / Q000000981:diagnostic imaging*; D010392:Pemphigus / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; (18)F-FDG PET/TC; Inflammatory myofibroblastic tumor; Metastatic; Metastásico; Paraneoplastic pemphigus; Pénfigo paraneoplásico; Retroperitoneal; Tumor miofibroblástico inflamatorio