Early detection of an endometrial cancer on health screening by PET/CT

Nan-Jing Peng, MD Department Nuclear Medicine

Abstract: Whole-body FDG-PET has been used to screen underlying malignancy of health people for decades. Recently, PET/CT has been advocated as a tool for improvement of diagnosis by FDG-PET. We assessed the PET/CT results of asymptomatic individuals for health screening in our PET center. The final confirmation of cancer was based on pathologic report. Here, a case of endometrial cancer was presented.

PET/CTThere are several abnormal FDG-avid areas including :1. two hot spots in the thyroid gland (SUV max early: 5.8, delayed: 10.5 on the left, and SUV max early: 4.0, delayed: 4.3 on the right).2. diffuse high FDG uptake in the central portion of uterus (SUV max & mean: early: 10.3 & 9.2, delayed: 16 & 12.8).

Ancillary tumor markers and thyroid hormone tests were also performed, which showed all within normal limits. Tracing her history, endometrial hyperplasia is noted for one and half a years.

Impression:1. Certain lesions in the thyroid gland, especially the left one. Malignant tumor can’t be ruled out. 2. Compatible with endometrial hyperplasia. Malignancy can’t be completely ruled out.

Pathological diagnosis:

#08 Uterus, labelled "endocervix", D&C ----- Adenocarcinoma, endometroid type, FIGO grade 1

#01 Uterus, endometrium, ATH+BSO+BPLND+para-aortic LN sampling----Adenocarcinoma, endometrioid type, moderately differentiated without lymph nodal metastasis