Clinical History
46-year-old lady with THBSO and omentectomy, followed by chemotherapy for ovarian carcinoma in 2002. Had resection of rectum for recurrence in August 2002, followed by chemotherapy. Had further chemotherapy from June 2004 till January 2005 for recurrence. Recently elevated LDH with CEA and CA-125 within normal limits. PET-CT to assess disease status.
Findings
The current study was compared with the previous scan of October 2008.
The patient is status post hysterectomy and bilateral salpingo-oophorectomy. No ascites or FDG-avid peritoneal nodules are noted. No hydronephrosis is detected.
October 2008
September 2009
There are no FDG-avid pelvic, retroperitoneal or intra-abdominal nodes. The non FDG-avid subcentimeter bilateral inguinal nodes are more in keeping with reactive nodes.
One large 8.0 x 5.6 cm hypermetabolic FDG avid hypodense right hepatic lobe lesion is present (SUVmax of 11.5). It has an ametabolic centre consistent with necrosis. No abnormal FDG-avid focus is seen in the spleen, pancreas or adrenal glands.
No FDG-avid hilar, mediastinal or supraclavicular nodes are noted. The stable non FDG-avid subcentimeter precarinal, bilateral paratracheal, bilateral axillary as well as bilateral cervical/jugular nodes are more in keeping with reactive nodes.
No abnormal FDG-avid focus is noted in either of the breasts. No FDG-avid focus or suspicious nodule is seen in the lungs. Linear atelectasis is present in the left lower lobe. No pleural or pericardial effusion is noted.
No FDG avid skeletal foci are detected.
Clinical Impression
The FDG avid liver lesion is suggestive of liver metastases. However, in view of solitary nature of lesion, with normal CEA and CA-125, the possibility of a liver primary should be ruled out.
Awaiting biopsy results.
No other FDG avid metastatic foci are detected elsewhere.
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