False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography: A case report of cholecystitis simulating a hepatic lesion

Neil Hansen, Richard K.J. Brown, Asra Khan, Kirk A. Frey, Mark Orringer

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation.This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake.This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.

Original languageEnglish (US)
Pages (from-to)409-412
Number of pages4
JournalClinical nuclear medicine
Volume35
Issue number6
DOIs
StatePublished - Jun 1 2010

Fingerprint

Cholecystitis
Positron-Emission Tomography
Carcinoma
Liver
Fluorodeoxyglucose F18
Esophageal Neoplasms
Endosonography
Esophagectomy
Cholecystectomy
Acute Disease
Gallbladder
Abscess
Chronic Disease
Tomography
Magnetic Resonance Imaging
Pathology
Biopsy
Positron Emission Tomography Computed Tomography
Incidence
Therapeutics

Keywords

  • Cholecystitis
  • Esophageal cancer
  • False positive
  • PET
  • Staging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography : A case report of cholecystitis simulating a hepatic lesion. / Hansen, Neil; Brown, Richard K.J.; Khan, Asra; Frey, Kirk A.; Orringer, Mark.

In: Clinical nuclear medicine, Vol. 35, No. 6, 01.06.2010, p. 409-412.

Research output: Contribution to journalArticle

@article{6074f87bf51d49e190cda4fe6113142c,
title = "False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography: A case report of cholecystitis simulating a hepatic lesion",
abstract = "Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation.This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake.This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.",
keywords = "Cholecystitis, Esophageal cancer, False positive, PET, Staging",
author = "Neil Hansen and Brown, {Richard K.J.} and Asra Khan and Frey, {Kirk A.} and Mark Orringer",
year = "2010",
month = "6",
day = "1",
doi = "10.1097/RLU.0b013e3181db4cd2",
language = "English (US)",
volume = "35",
pages = "409--412",
journal = "Clinical Nuclear Medicine",
issn = "0363-9762",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - False positive diagnosis of metastatic esophageal carcinoma on positron emission tomography

T2 - A case report of cholecystitis simulating a hepatic lesion

AU - Hansen, Neil

AU - Brown, Richard K.J.

AU - Khan, Asra

AU - Frey, Kirk A.

AU - Orringer, Mark

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation.This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake.This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.

AB - Esophageal cancer has been increasing in incidence for the last several decades. The current staging evaluation includes computed tomography, endoscopic ultrasonography, and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), which influences the treatment options. PET/CT is limited in its ability to differentiate hypermetabolic metastatic disease from acute/chronic inflammatory conditions, and this must be considered during interpretation.This is the case report of a 77-year-old man with esophageal cancer whose PET/CT demonstrated increased F-18 FDG uptake in the right lobe of the liver. This was originally interpreted at an outside institution as suspicious for metastatic disease, which would have precluded potential surgical cure. Subsequent reinterpretation and additional imaging including magnetic resonance imaging suggested that the uptake in the liver was likely due to adjacent gallbladder inflammation. On the basis of this interpretation, an abdominal exploration, liver biopsy, cholecystectomy, and transhiatal esophagectomy were performed. Final pathology of the gallbladder revealed perforated cholecystitis and a pericholecystic abscess (related to a prior septic episode), which were responsible for the increased radiotracer uptake.This case is presented to illustrate the importance of considering benign etiologies that may mimic metastatic disease when interpreting PET/CT scans.

KW - Cholecystitis

KW - Esophageal cancer

KW - False positive

KW - PET

KW - Staging

UR - http://www.scopus.com/inward/record.url?scp=77952468026&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952468026&partnerID=8YFLogxK

U2 - 10.1097/RLU.0b013e3181db4cd2

DO - 10.1097/RLU.0b013e3181db4cd2

M3 - Article

C2 - 20479586

AN - SCOPUS:77952468026

VL - 35

SP - 409

EP - 412

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

SN - 0363-9762

IS - 6

ER -