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Case Reports
. 2022 Dec 7;2022(12):rjac524.
doi: 10.1093/jscr/rjac524. eCollection 2022 Dec.

18F-FDG PET/CT scan standardised uptake value (SUV) score for diagnosis, staging and monitoring malignancy in spinal melanotic schwannoma

Shahnawaz Haleem  1 , Mohamed H Mahmoud  2 , Gurvinder Singh Kainth  1 , Rajesh Botchu  1 , Md Faizul Hassan  1
Affiliations
Case Reports

18F-FDG PET/CT scan standardised uptake value (SUV) score for diagnosis, staging and monitoring malignancy in spinal melanotic schwannoma

Shahnawaz Haleem et al. J Surg Case Rep. .

Abstract

Melanotic schwannoma (MS) is a rare nerve sheath neuroectodermal neoplasm. We highlight the use of F18-fluorodeoxyglucose positive emission tomography/computed tomography (18F-FDG PET/CT) standardised uptake value (SUV) results in the diagnosis, staging and monitoring of spinal MS. A 58-year-old female patient had a 6-month history of left leg pain (S1) and no skin lesions. Magnetic resonance imaging reported a possible schwannoma with CT-guided biopsy, indicating a metastatic malignant melanoma. 18F-FDG PET/CT scan revealed only sacral destruction and an SUV score of 3.6. Histopathology results confirmed a malignant melanotic peripheral nerve sheath tumour (schwannoma). In MS, the 18F-FDG PET/CT scan SUV cut-off point can be used to distinguish between benign and malignant lesions, whereas (SUVmax) can predict the histologic response and therefore useful as a 'screening test'. Our case highlights the increased uptake on PET/CT by melanocytic variant of neurogenic tumours and clinicians need to be aware of this.

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Figures

Figure 1
Figure 1
T2-weighted axial images of the MRI scan.
Figure 2
Figure 2
T2-weighted sagittal images of the MRI scan.
Figure 3
Figure 3
Coronal image of 18F-FDG PET/CT scan showing MS.
Figure 4
Figure 4
Axial image of 18F-FDG PET/CT scan showing MS.
Figure 5
Figure 5
Histopathology slide with the tumour being composed of fascicles and pleomorphic cells obscured by the melanin pigment.
See this image and copyright information in PMC

References

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