PMC4898935_01
Maximum intensity projection (MIP) (A) and PET, CT and fusion images in the axial (B) and sagittal (C) planes. MIP image demonstrates intense uptake in the rectum and in the pelvis to the left of the urinary bladder. Axial and sagittal images demonstrate intense uptake (SUVmax = 17.4) localising to a rectal soft tissue mass. Note on the MIP image symmetric bilateral circumferential hyper-metabolism surrounding the joints in the upper and lower extremities consistent with the known history of rheumatoid arthritis.
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figure1
FDG-avid left femoral lymph node and intense uptake in the left posterior rectum corresponding to a 1 cm nodule palpable on digital exam that was concerning for malignancy (Figure 1a-c) in addition to the previously identified left pelvic mass (Figure 2a-c) that was responsible for her initial symptoms. Further workup with colonoscopy and biopsies confirmed an unusual basaloid SCC of the rectum approximately 5 cm above the anal verge with positive p16 expression, a surrogate marker for HPV status.
Axial PET(A), CT (B) and fusion (C) images of the pelvis demonstrating intense uptake (SUVmax = 21.9) within an irregularly marginated soft tissue mass at the pelvic sidewall containing punctate calcifications, consistent with the biopsy-proven metastatic squamous cell carcinoma.
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figure2
FDG-avid left femoral lymph node and intense uptake in the left posterior rectum corresponding to a 1 cm nodule palpable on digital exam that was concerning for malignancy (Figure 1a-c) in addition to the previously identified left pelvic mass (Figure 2a-c) that was responsible for her initial symptoms. Further workup with colonoscopy and biopsies confirmed an unusual basaloid SCC of the rectum approximately 5 cm above the anal verge with positive p16 expression, a surrogate marker for HPV status.