FDG Avid Intracholecystic Papillary Neoplasm Mimicking Hepatic Metastasis in a Patient with Head-and-neck Cancer

Overview

Journal Indian J Nucl Med

Specialty Nuclear Medicine

Date 2024 Jul 11

PMID 38989299

Authors

Jordan Norman

Elizabeth Ellison

Jamie Kendrick

Jing He

Peeyush Bhargava

Affiliations

Soon will be listed here.

Abstract

A 75-year-old male with head-and-neck squamous cell cancer received a staging f-18-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET/CT) scan which showed additional focal abnormal uptake in the right hepatic lobe. The patient was treated for probable metastatic disease. Restaging FDG PET/CT scan revealed resolution of uptake in the head-and-neck and persistent focal uptake in the presumed liver metastasis. An abdominal CT with intravenous contrast revealed an enhancing mass in the gallbladder, without extension into the liver. Cholecystectomy revealed an intracholecystic papillary neoplasm of the gallbladder. The initial appearance of hepatic metastasis was due to a misregistration artifact.

References

Sakai A, Masuda A, Shiomi H, Zen Y, Ajiki T . Intracholecystic papillary neoplasm of the gallbladder protruding into the common bile duct. Gastrointest Endosc. 2018; 88(2):405-406. DOI: 10.1016/j.gie.2018.02.026. View

Lin E . Apparent posterior misregistration of a liver lesion on PET/CT: pitfall secondary to partial hepatectomy. Clin Nucl Med. 2008; 33(3):215-7. DOI: 10.1097/RLU.0b013e318162db5f. View

Kumagai H, Umemura A, Nitta H, Katagiri H, Nishiya M, Uesugi N . Extensively Invasive Gallbladder Cancer from Intracholecystic Papillary Neoplasm Treated with Pylorus-Preserving Pancreaticoduodenectomy and Extended Cholecystectomy: A Case Report and Literature Review. Case Rep Surg. 2023; 2023:5825045. PMC: 10314817. DOI: 10.1155/2023/5825045. View

Jayaprakasam V, Paroder V, Schoder H . Variants and Pitfalls in PET/CT Imaging of Gastrointestinal Cancers. Semin Nucl Med. 2021; 51(5):485-501. PMC: 8338802. DOI: 10.1053/j.semnuclmed.2021.04.001. View

Ismail R, Bamashmos A, Cohen P, Pucar D . Intracystic Papillary Neoplasm of Gallbladder Mimicking Metastatic Malignancy on PET/CT. Clin Nucl Med. 2020; 46(7):e363-e364. DOI: 10.1097/RLU.0000000000003442. View

Kinahan P, Fletcher J . Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. Semin Ultrasound CT MR. 2010; 31(6):496-505. PMC: 3026294. DOI: 10.1053/j.sult.2010.10.001. View

Adsay V, Jang K, Roa J, Dursun N, Ohike N, Bagci P . Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. Am J Surg Pathol. 2012; 36(9):1279-301. DOI: 10.1097/PAS.0b013e318262787c. View

Wang X, Koch S . Positron emission tomography/computed tomography potential pitfalls and artifacts. Curr Probl Diagn Radiol. 2009; 38(4):156-69. DOI: 10.1067/j.cpradiol.2008.01.001. View

Israel O, Yefremov N, Bar-Shalom R, Kagana O, Frenkel A, Keidar Z . PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med. 2005; 46(5):758-62. View

10.

Hamedani F, Garcia-Buitrago M . Intracholecystic Papillary-Tubular Neoplasms (ICPN) of the Gallbladder: A Short Review of Literature. Appl Immunohistochem Mol Morphol. 2019; 28(1):57-61. DOI: 10.1097/PAI.0000000000000711. View

11.

Parihar A, Dehdashti F, Wahl R . FDG PET/CT-based Response Assessment in Malignancies. Radiographics. 2023; 43(4):e220122. DOI: 10.1148/rg.220122. View

12.

Choi K, Baek H . Incarcerated ovarian herniation of the canal of Nuck in a female infant: Ultrasonographic findings and review of literature. Ann Med Surg (Lond). 2016; 9:38-40. PMC: 4925906. DOI: 10.1016/j.amsu.2016.06.003. View

13.

Gould K, Pan T, Loghin C, Johnson N, Guha A, Sdringola S . Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections. J Nucl Med. 2007; 48(7):1112-21. DOI: 10.2967/jnumed.107.039792. View