18F-FDG PET/CT Findings of Ovarian Mesothelioma: A Case Study

Our plain-English summary of 18F-FDG PET/CT Findings of Ovarian Mesothelioma: A Case Study, by R. Sun, Y. Chen, Z. Huang (Clinical Nuclear Medicine, 2019).

The study

• Authors: R. Sun, Y. Chen, Z. Huang
• Journal: Clinical Nuclear Medicine
• Published: 2019;44(11):925-926
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Ovarian mesothelioma is a rare and aggressive tumor. Early diagnosis of the disease is difficult, delaying effective treatment. Here we report a 50-year-old woman who was referred for an F-FDG PET/CT imaging to assess her newly detected left ovarian mass. The images not only demonstrated a hypermetabolic mass in the left ovary, but also several hepatic low densities with increased FDG uptake, which suggested ovarian malignancy with hepatic metastases. Mesothelioma was diagnosed histopathologically following the biopsy. Our case demonstrates PET/CT findings observed in ovarian mesothelioma.

In plain English

This article is a case report about one 50-year-old woman with mesothelioma of the ovary. The article states she had no history of asbestos exposure and that she had fatigue and upper abdominal pain. Ultrasound found a mass in the pelvis close to the left ovary, pelvic CT showed the mass was in the left ovary, and an 18F-FDG PET/CT scan was done for staging. The ovarian mass showed intense tracer uptake (SUVmax 28.9) and had invaded nearby tissue. Several low-density areas in the liver also showed increased uptake (SUVmax 3.2 to 8.2). These findings supported ovarian cancer that had spread to the liver. A needle biopsy of the ovarian mass gave a diagnosis of mesothelioma. Surgery was judged unlikely to benefit her, so chemotherapy with paclitaxel and cisplatin was started. Her symptoms did not respond after one cycle, and she declined further treatment. The authors concluded that the case supports the view that PET/CT is useful for staging mesothelioma. A single case does not show how often this occurs.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (published as a short image report)
• Who was studied: one 50-year-old woman with fatigue and upper abdominal pain; no history of asbestos exposure; place and date of care not stated
• Exposure: no asbestos exposure in the patient's history, according to the article
• Main results:
  • Ultrasound showed an irregular mass in the pelvic cavity close to the left ovary.
  • Pelvic CT showed that the pelvic mass was located in the left ovary.
  • Ultrasound and CT suggested possible cancer, which led to an 18F-FDG PET/CT scan for staging.
  • The ovarian mass had an SUVmax of 28.9 on PET.
  • The ovarian mass had invaded adjacent tissue.
  • Several areas in the liver showed increased uptake, with SUVmax ranging from 3.2 to 8.2, corresponding to low-density areas on CT.
  • Bone marrow uptake was increased because of moderate anemia (hemoglobin 60 g/L).
  • The PET/CT findings supported a diagnosis of ovarian cancer with spread to the liver.
  • A needle biopsy of the ovarian mass gave a diagnosis of mesothelioma.
  • Immunohistochemistry of the tumor cells: PCK minor positive; EMA, CK5/6 and WT1 positive; D2-40 negative.
  • Surgery was not considered beneficial, so chemotherapy with paclitaxel and cisplatin was started.
  • Her symptoms did not respond after one cycle, and she declined further treatment.
• The authors' conclusion: The authors concluded that their case supports the view that PET/CT is useful for staging patients with mesothelioma, particularly when surgery is not an option.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Biopsy.

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• The global burden and associated factors of ovarian cancer in 1990-2019: findings from the Global Burden of Disease Study 2019 — S. Zhang, C. Cheng, et al. (2022)
• Whole-Body MRI: Comparison of Its Capability for TNM Staging of Malignant Pleural Mesothelioma With That of Coregistered PET/MRI, Integrated FDG PET/CT, and Conventional Imaging — Y. Ohno, M. Yui, et al. (2019)
• Present and future roles of FDG-PET/CT imaging in the management of malignant pleural mesothelioma — K. Kitajima, H. Doi, et al. (2016)
• 18F-Fluorodeoxyglucose PET/CT and dynamic contrast-enhanced MRI as imaging biomarkers in malignant pleural mesothelioma — D.O. Hall, C.E. Hooper, et al. (2018)
• Focal Peritoneal Mesothelioma Demonstrated on FDG PET/CT — J. Xiao, H. Yin, et al. (2019)

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