Metastatic ovarian cancer:

18F-FDG PET/CT imaging

Fig. 1: Exemplary lymph node metastases

Enlarged lymph nodes with high FDG uptake iliac (left arrow, SUVmax 8,2) and pelvic (middle / right arrow, SUVmax 11). Ileostomy in the right lower abdomen.

Fig. 2: Peritoneal carcinosis in all four quadrants

Pertioneal tumor mass adjacent to liver and spleen with scalloping and high FDG uptake (SUVmax 9,8). Steatosis hepatis.

Fig. 3: Peritoneal carcinosis in all four quadrants

Mesenteric and pertioneal tumor mass in the lower quadrants of the abdomen with high FDG uptake (SUVmax 15). Atherosclerosis.

Fig. 4: Peritoneal carcinosis in all four quadrants

Peritoneal tumor mass in all four quadrants of the abdomen with high FDG uptake (SUVmax 15).  Right-sided leural effusion.

Description:

Female patient with papillary serous ovarian cancer (PSOC) (pT3c pN1 G3, FIGO IIIC) s/p tumor resection, hysterectomy with double adnexectomy, peritoneal resection, lymph node dissection (pelvic, paraaortocaval, proctosigmoidectomy).

Recent PET/CT scan was performed during chemotherapy (PLD), revealing therapy progress with hematogenous dissemination (pulmonary, hepatic), peritoneal carcinosis in all four quadrants and lymphatic dissemination (cardiophrenic, mediastinal, pelvic, iliac, inguinal), respectively.