Peritoneal Carcinomatosis From Cervical Cancer Detected by F-18 FDG Positron Emission Tomography

Abstract

A 41-year-old woman with a history of rheumatoid arthritis and newly diagnosed cervical carcinoma was treated with cisplatin and whole-pelvis radiotherapy with minimal response. Computed tomographic scan of the abdomen and pelvis at the time of diagnosis demonstrated no evidence of extrapelvic disease. She underwent F-18 fluorodeoxyglucose (FDG-PET) imaging to evaluate for extrapelvic extension of disease for consideration of total pelvic exenteration. Coronal and axial reconstructed images revealed a large pelvic mass with evidence of diffuse FDG uptake along the peritoneal surfaces of the abdomen and pelvis, consistent with diffuse peritoneal implants. Subsequent diagnostic laparoscopy demonstrated a large omental cake with diffuse carcinomatosis, biopsy positive for metastatic squamous cell carcinoma, and a small amount of ascites. The patient declined further treatment and died of her disease approximately one month later.