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Journal of Medical Case Reports

, 1:99

First Online: 20 September 2007Received: 08 June 2007Accepted: 20 September 2007DOI: 10.1186-1752-1947-1-99

Cite this article as: Rehani, B., Chasen, R.M., Dowdy, Y. et al. J Med Case Reports 2007 1: 99. doi:10.1186-1752-1947-1-99


BackgroundAn accurate, early diagnosis and treatment of adenomatous polyp can curtail progression to colorectal cancer. F-18 fluorodeoxyglucose positron emission tomography F-18 FDG PET reveals the biochemical changes associated with the development of many cancers which precede the appearance of gross anatomical changes that may be visualized during surgical resection or via imaging with MR or CT.

InterventionWe detail the history of a 64 year old female who had a whole-body FDG PET scan as a part of an employee wellness program. A dose of 12.2 mCi of F-18 labeled FDG was administered.

ResultsA focal cecal uptake with a standardized uptake value SUV of 8.9 was found on the PET scan. Conversely, only normal mucosa was observed during a colonoscopy done 2 months after the PET scan. Motivated by the PET scan finding, the colonoscopist performed a biopsy which revealed a villous adenoma without high grade dysplasia. Pathology from tissue extracted during an exploratory laparatomy completed one month later found the lesion to be a villous adenoma with high grade dysplasia.

ConclusionWhole-body FDG PET scan revealed the biochemical metabolic changes in malignancy that preceded the appearance of any gross anatomical abnormality. A positive FDG PET scan indicative of colorectal cancer should be followed up with a colonoscopy and biopsy even in a visibly normal mucosa.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-1-99 contains supplementary material, which is available to authorized users.

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Autor: Bhavya Rehani - Richard M. Chasen - Yvonne Dowdy - Ankur Bharija - Martin Satter - Pamela Strohmeyer - Joseph Mantil


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