PMC5892258_01
Fused axial image of 18-FDG-PET/CT scan shows 18-FDG uptake of thrombus in the superior mesenteric vein. This finding was considered as hypermetabolic tumor thrombus.
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The PET-CT revealed a hypermetabolic mass in the gastric anastomosis site along with hypermetabolic activity in the superior mesenteric vein (SMV) suspected with tumor thrombus (Figure 1).
Axial (a), coronal (b), and sagittal (c) slices of abdominal CT show contrast media defect due to tumor thrombus (arrows) in the superior mesenteric vein.
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fig2
A contrast-enhanced thrombus misgiving for tumor was detected within a 4 cm segment of the SMV proximal to the splenic confluence that completely obstructed the lumen on triphasic computed tomography (Figure 2).
The SMV dissection near the splenic confluence.
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Firstly, to ensure that thrombus was tumor, the SMV was dissected and opened vertically near the splenic confluence under vascular control (Figure 3).
Extirpated tumor thrombus within the SMV.
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Fogarty catheter (Figure 4). Following recanalization of the SMV, reflow was allowed and the vein was closed with primary repair.
H&E (x100) shows tumor cells (arrow) in bloody background.
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fig5
Lesions removed from the SMV have been reported to be tumor thrombi (T4N2M1) (Figure 5).