Nucl Med Mol Imaging.  2023 Oct;57(5):251-253. 10.1007/s13139-023-00796-4.

Bilateral Ovarian Metastases of Hepatocellular Carcinoma Diagnosed with  ¹⁸F‑Fluorocholine PET/CT in a Patient with Endometriosis

• Latgé A
• Averous G
• Gressel A
• Faitot F
• Leroy‑Freschini B

• KMID: 2547015
• DOI: http://doi.org/10.1007/s13139-023-00796-4

Abstract

A 47-year-old woman with history of hepatocellular carcinoma was referred for ¹⁸F-fluorocholine PET/CT evaluation due to elevated alpha-fetoprotein. The examination showed several peritoneal uptakes and two nodular pelvic foci. Coelioscopic exploration allowed confirmation and resection of multiple peritoneal metastases from hepatocellular carcinoma while pelvic biopsies revealed endometriosis and endosalpingiosis. However, alpha-fetoprotein kept rising: subsequent ¹⁸F-fluorodesoxyglucose PET/CT exploration found no pelvic uptake, while ¹⁸F-fluorocholine PET/CT revealed intense tracer accumulation in the two pelvic masses corresponding to bilateral ovarian metastases of hepatocellular carcinoma. We highlight the importance of ¹⁸F-fluorocholine PET/CT in hepatocellular carcinoma especially in patients with confounding comorbidities such as endometriosis.

Keyword

Hepatocellular carcinoma; Ovarian metastases; Endometriosis; ¹⁸F-Fluorocholine PET/CT ; ¹⁸F-FDG PET/CT