Abstract
BackgroundAn accurate, early diagnosis and treatment of adenomatous polyp can curtail progression to colorectal cancer. F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) reveals the biochemical changes associated with the development of many cancers which precede the appearance of gross anatomical changes that may be visualized during surgical resection or via imaging with MR or CT.InterventionWe detail the history of a 64 year old female who had a whole-body FDG PET scan as a part of an employee wellness program. A dose of 12.2 mCi of F-18 labeled FDG was administered.ResultsA focal cecal uptake with a standardized uptake value (SUV) of 8.9 was found on the PET scan. Conversely, only normal mucosa was observed during a colonoscopy done 2 months after the PET scan. Motivated by the PET scan finding, the colonoscopist performed a biopsy which revealed a villous adenoma without high grade dysplasia. Pathology from tissue extracted during an exploratory laparatomy completed one month later found the lesion to be a villous adenoma with high grade dysplasia.ConclusionWhole-body FDG PET scan revealed the biochemical metabolic changes in malignancy that preceded the appearance of any gross anatomical abnormality. A positive FDG PET scan indicative of colorectal cancer should be followed up with a colonoscopy and biopsy even in a visibly normal mucosa.
Highlights
An accurate, early diagnosis and treatment of adenomatous polyp can curtail progression to colorectal cancer
Whole-body FDG PET scan revealed the biochemical metabolic changes in malignancy that preceded the appearance of any gross anatomical abnormality
We hereby report a case of advanced adenoma which was detected on a whole-body FDG PET scan despite the fact that the mucosa had a normal appearance on follow up colonoscopy
Summary
Early diagnosis and treatment of adenomatous polyp can curtail progression to colorectal cancer. F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) reveals the biochemical changes associated with the development of many cancers which precede the appearance of gross anatomical changes that may be visualized during surgical resection or via imaging with MR or CT. We hereby report a case of advanced adenoma which was detected on a whole-body FDG PET scan despite the fact that the mucosa had a normal appearance on follow up colonoscopy. F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) reveals the biochemical (page number not for citation purposes). Journal of Medical Case Reports 2007, 1:99 http://www.jmedicalcasereports.com/content/1/1/99 changes associated with the development of many cancers which precede the appearance of gross anatomical changes that may be visualized during surgical resection or via imaging with MR or CT
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