Inferior Vena Cava Tumour Thrombus from Nonseminomatous Germ Cell Tumour Detected with F-18 FDG PET/CT
DOI:
https://doi.org/10.6000/1929-2279.2013.02.01.6Keywords:
Nonseminomatous germ cell tumour, F-18 FDG PET/CT, tumour thrombus, testicular carcinoma.Abstract
21-year-old male presented with recently diagnosed metastatic nonseminomatous germ cell tumour and left orchidectomy. CT demonstrated mixed density in the inferior vena cava (IVC) extending from the union of the common iliac veins to the level of the liver just below the confluence of the hepatic veins. Retroperitoneal nodal disease and deposits in the left lung were suspicious for metastatic deposits. F-18Flurodeoxyglucose (FDG) PET/CT images demonstrated avid FDG uptake within the lumen of the IVC from the level of the renal veins, with extension into both renal veins, to the level of T10.
While benign and malignant thrombi have previously been demonstrated on F18-FDG PET imaging, this case highlights the use of F-18 FDG PET/CT when identifying tumour thrombosis in patients with nonseminomatous germ cell tumour.
References
Zincirkeser S, Sahin E, Sager S. Standardized uptake values of normal organs on f-18 Fluorodeoxyglucose positron emission tomography and computed tomography imaging. J Int Med Res 2007; 35: 231-36.
Do B, Mari C, Biswal S, Kalinyak J, Quon A, Gambhir SS. Diagnosis of aseptic deep venous thrombosis of the upper extremity in a cancer patient using fluoro-18 fluorodeoxyglucose positron emission tomography/ computerized tomography (FDG PET-CT). Ann Nucl Med 2006; 20: 151-55. http://dx.doi.org/10.1007/BF02985628
Miceli M, Atoui R, Walker R, Mahfouz T, Mirza N, Diazet J, et al. Diagnosis of deep septic thrombophlebitis in cancer patients by fluorine-18 fluorodeoxyglucose positron emission tomography scanning: a preliminary report. J Clin Oncol 2004; 22: 1949-56. http://dx.doi.org/10.1200/JCO.2004.10.160
Sone, T, Yoshikawa K, Fukunaga M. Pulmonary tumor embolism from choriocarcinoma: detection with F-18 FDG positron emission tomography. Clin Nucl Med 2008; 33: 773-74. http://dx.doi.org/10.1097/RLU.0b013e318187f0d7
Khandelwal AR, Li G, Takalkar AM. Incidental detection of unsuspected pulmonary embolism on oncologic FDG PET/CT images. Clinl Nucl Med 2011; 36: 720-22. http://dx.doi.org/10.1097/RLU.0b013e318219b102
Sharma P, Kumar R, Jeph S, Karunanithi S, Naswa N, Gupta A, et al. F-18 FDG PET-CT in the diagnosis of tumor thrombus: can it be differentiated from benign thrombus? Nucl Med Communs 2011; 32: 782-88. http://dx.doi.org/10.1097/MNM.0b013e32834774c8
Gupta P, Kramer E, Ponzo F. FDG uptake in tumour thrombus in inferior vena cava from rectal cancer on positron emission tomography. Clinl Nucl Med 2005; 30: 342-43. http://dx.doi.org/10.1097/01.rlu.0000159683.54083.17
Krause BJ, Beyer T, Bockisch A, et al. FDG-PET/CT in oncology. German Guideline Nuklearmedizin 2007; 46: 291-301.
Tripathi M, D’Souza M, Jain J, et al. Metastatic choriocarcinoma with tumor thrombus in the right atrium and pulmonary vessels. Clin Nucl Med 2009; 34: 381-85. http://dx.doi.org/10.1097/RLU.0b013e3181a3461f
Tripathi M, Sharma R, Jaimini A, et al. Metastatic follicular carcinoma of the thyroid with tumor thrombus in the superior vena cava and right brachiocephalic and internal jugular veins. Clin Nucl Med 2008; 33: 426-28. http://dx.doi.org/10.1097/RLU.0b013e318170d508
Hain SF, Gleadle J, Maisey M. F-18 fluorodeoxyglucose PET in the diagnosis of vascular invasion in renal cell carcinoma. Clin Nucl Med 1999; 24: 819-20. http://dx.doi.org/10.1097/00003072-199910000-00026
Radecka E, Brekkan E, Juhlin C, et al. An unusual case of tumor thrombus in the inferior vena cava. Acta Radiol 2003; 44: 160. http://dx.doi.org/10.1034/j.1600-0455.2003.00027.x