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. 2011 Sep;45(3):223-8.
doi: 10.1007/s13139-011-0089-5. Epub 2011 Jun 30.

Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and (18)F-FDG PET/CT

Rajan Rakheja  1 , William Makis  2 , Marc Hickeson  1
Affiliations

Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and (18)F-FDG PET/CT

Rajan Rakheja et al. Nucl Med Mol Imaging. 2011 Sep.

Abstract

A 20-year-old woman, who presented with a several-week history of abdominal pain, was referred for magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after an ultrasound showed complex cystic masses arising from both ovaries. The MRI and (18)F-FDG PET/CT imaging characteristics of the ovarian masses were strongly suspicious for malignancy, and the masses were surgically removed. Histopathological evaluation revealed a bilateral tubo-ovarian abscess, with no evidence of malignancy. This case highlights a potentially serious pitfall in the evaluation of suspicious pelvic masses by (18)F-FDG PET/CT, whereby a complex bilateral tubo-ovarian abscess may mimic the PET/CT imaging characteristics of an ovarian or pelvic malignancy.

Keywords: FDG; Fluorodeoxyglucose; Ovarian cancer; PET; Tubo-ovarian abscess.

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Figures

Fig. 1
Fig. 1
Coronal views of the pelvis on (a) T2-weighted FSE (fast spin echo) MRI, (b) contrast-enhanced CT, and corresponding 18F-FDG PET/CT with (c) PET, (d) PET/CT fusion, and (e) the CT portion of the PET/CT images show two large complex mixed cystic and solid masses that were suspicious for ovarian or pelvic malignancy, but were histologically shown to be bilateral TOA. The PET/CT showed intense 18F-FDG uptake in the two pelvic masses, with SUVmax of 13.3 in the 3.5-cm right adnexal mass, and SUVmax of 15.6 in the 5-cm left adnexal mass
Fig. 2
Fig. 2
Transaxial views of the pelvis on (a) T2-weighted FSE MRI, (b) contrast-enhanced CT, and corresponding 18F-FDG PET/CT with (c) PET, (d) PET/CT fusion, and (e) the CT portion of the PET/CT images show the two large complex pelvic masses with evidence of invasion into the sigmoid bowel wall
Fig. 3
Fig. 3
18F-FDG PET/CT whole-body maximum-intensity projection (MIP) images with anterior and left lateral views show the two intensely FDG-avid pelvic masses with no other FDG-avid abnormalities in the remainder of the body
See this image and copyright information in PMC

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