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CANCER MIMICKING INJECTION SITE
Authored By: Farrokh Dehdashti and Brandon Peters.
Patient: 24 year old male
History: 24-year-old male with epitheliod sarcoma is referred for evaluation of metastases.
Image Size:[small][as-submitted]

Fig. 1
Coronal whole body FDG PET images

Fig. 2
Axial thoracic PET images

Fig. 3
PET/CT/ and fused PET/CT images showing the tracer avid epitheliod sarcoma of the left hand

Fig. 4
Axial PET/CT / and fused PET/CT images demonstrating tracer avid left axillary lymph nodes
Image Size:[small][as-submitted]

Findings: 14.8 mCi FDG iv.

FDG-PET/CT images demonstrate a focal intense tracer accumulation involving the left hand.  Additionally, there is a focus of increased tracer in the left axilla within an axillary lymph node. 
Diagnosis: Epitheliod sarcoma of left hand. 
General Discussion: 24-year-old man with slowly developing ulcerative lesion involving the skin of the hypothenar region of the left hand.  Biopsy subsequently demonstrated epitheliod sarcoma.

The patient was injected in the right hand.  Although tracer accumulation in the wrists and hands is assumed to be small residual tracer at the injection site, such foci of increased uptake can represent the primary site of disease.  Although the tracer accumulation in the left axilla was considered suspicious for metastatic lymphadenopathy, no cancer was demonstrated in the lymph nodes on pathologic evaluation of material obtained at axillary dissection. 
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Additional Details:

Case Number: 206879Owner(s): Farrokh Dehdashti and Brandon PetersLast Updated: 12-07-2011
Anatomy: Skeletal System   Pathology: Neoplasm
Modality: PETAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: sarcoma, ptnmACR: 40000.37000

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Certified by Farrokh Dehdashti on 05-02-2008

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