Abstract
Positron emission tomography–computed tomography (PET/CT) improves the diagnostic interpretation of fluorine-18 fluorodeoxyglucose (18F-FDG ) PET and CT in oncologic patients and has an impact on both diagnostic and therapeutic aspects of patient management. However, false positive findings from the PET/CT imaging should be taken into consideration as they mislead physicians into improper therapeutic actions. We present a 48-year-old female patient with a history of left colectomy for colorectal cancer and subsequent liver metastasectomy. After one year of follow-up, she presented with a highly suspicious lesion in the liver, which was confirmed on PET/CT as a metastatic liver tumor. Consequently, the patient underwent surgical excision of the tumor, and the definitive histological diagnosis showed a granulomatous tissue with giant cells and foreign body tissue reaction. Based on this report, we briefly review the dangerous pitfalls from radiological and PET/CT imaging concerning the preoperative diagnostic workup examination, as they may significantly alter the treatment plan in oncologic patients.
Highlights
Staging and follow-up of oncologic patients rely widely on radiologic imaging modalities' accuracy that can in turn directly influence therapeutic decisions. 18FDG - Positron emission tomography–computed tomography (PET/CT) scan benefits from the combination of functional and structural information providing a highly superior diagnostic accuracy and has been widely used in the detection of distant metastases [1]
As the liver is one of the commonest sites of metastasis, in particular for the tumors arising from the colon and rectum, liver imaging presents a common challenge in oncological evaluation by PET/CT
The practice of PET/CT in patients with colorectal cancer presented with hepatic metastases has been shown to improve therapeutic planning by detecting intrahepatic and extrahepatic sites of the disease
Summary
Staging and follow-up of oncologic patients rely widely on radiologic imaging modalities' accuracy that can in turn directly influence therapeutic decisions. 18FDG - PET/CT scan benefits from the combination of functional and structural information providing a highly superior diagnostic accuracy and has been widely used in the detection of distant metastases [1]. The practice of PET/CT in patients with colorectal cancer presented with hepatic metastases has been shown to improve therapeutic planning by detecting intrahepatic and extrahepatic sites of the disease. We present the case of a 48-year-old female patient with metastatic colorectal cancer, who was subjected to an avertable hepatic tumor resection following misleading findings in PET/CT scan, throughout her follow up. She underwent surgical excision of the suspicious tumor, which proved to be granulomatous tissue, secondary to inflammation with no metastases in the pathology report. The patient had an uneventful postoperative course and was discharged home on the fifth postoperative day
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