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INTERESTING IMAGE
Year : 2013  |  Volume : 28  |  Issue : 3  |  Page : 185-186  

18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging of extra-medullary plasmacytoma of the ovary


1 Department of Radiology, Division of Nuclear Medicine, Keck Medical Center, Keck School of Medicine,University of Southern California, Los Angeles, California, USA
2 Nuclear Medicine, Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey

Date of Web Publication9-Oct-2013

Correspondence Address:
Billur Caliskan
Abant Izzet Baysal Universitesi, Arastirma ve Uygulama Hastanesi Nukleer Tip AD, Bolu 14280
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.119517

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   Abstract 

Extrameduallary plasmacytoma of ovary is extremely rare. We report a case of involvement of ovary in a treated case of plasmacytoma of 2 nd part of duodenum, which was initially thought to be physiological luteal activity. However, follow up whole body FDG PET-CT scan shows appearance of metabolically active soft tissue mass in left adnexal region which confirmed to be extra-medullary plasmacytoma of ovary on histopathology.

Keywords: Extramedullary plasmacytoma, ovarian plasmacytoma, FDG PET-CT


How to cite this article:
Sheth S, Caliskan B, Seto J. 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging of extra-medullary plasmacytoma of the ovary. Indian J Nucl Med 2013;28:185-6

How to cite this URL:
Sheth S, Caliskan B, Seto J. 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging of extra-medullary plasmacytoma of the ovary. Indian J Nucl Med [serial online] 2013 [cited 2019 Dec 6];28:185-6. Available from: http://www.ijnm.in/text.asp?2013/28/3/185/119517

We report 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) of plasmacytoma of the ovary. A 38-year-old female with plasmacytoma of the second portion of the duodenum/pancreatic head, status post Whipple's procedure and radiation therapy, was found to have a hypermetabolic mass in the left ovary on a follow-up FDG PET/CT scan [Figure 1],[Figure 2],[Figure 3]. Subsequently, patient underwent hysterectomy and left salpingo-oophorectomy with pathology demonstrating plasmacytoma with anaplastic features. Extramedullary plasmacytoma represent 3% of all plasma cell neoplasms and involvement of the ovary is extremely rare. [1],[2] While plasmacytoma of the ovary is rare (eight reported cases), [1],[2],[3] knowledge of this presentation is important for accurate diagnosis. FDG PET scan is a useful tool in diagnosing and managing extramedullary plasmacytomas as reported previously. [1],[2],[3],[4],[5],[6],[7] This interesting case also illustrates the utility of FDG PET/CT in the evaluation of extramedullary plasmacytomas.
Figure 1: Patient presented initially in August 2011 with symptoms suggestive of gastric outlet obstruction. A biopsy revealed a solitary plasmacytoma in the duodenum, which was 5.4 cm in size. A staging positron emission tomography/computed tomography scan (a-d) revealed a mass in the duodenum with maximum standard uptake value by body weight (standardized uptake value max) of 11.4. In addition, there is ureteric activity in the pelvis and there was brown fat activity in the supraclavicular, cervical, paravertebral, axillary and mediastinal regions

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Figure 2: One month following radiation therapy of the duodenal plasmacytoma, maximum intensity projection image (a) of positron emission tomography/computed tomography demonstrated a hypermetabolic soft-tissue density in the left ovary, with standardized uptake value max of 9.4 that was attributed to corpus luteal activity. Five months following the initial diagnosis, a Whipple's procedure was performed. Subsequently a restaging PET/CT (b-f) showed FDG avid soft tissue mass in left adnexa with a SUV max of 8.7, raising suspicion for malignancy

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Figure 3: Fluorodeoxyglucose positron emission tomography/computed tomography scan (a-b) demonstrated no abnormal activity in left adnexal region one year after hysterectomy and left salpingoophorectomy

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   References Top

1.Santhosh S, Mittal BR, Raveendran A, Jain V, Nijhawan R, Kumar R, et al. Plasmacytoma of the ovary: Additional role of 18F-FDG PET/CT. Clin Nucl Med 2013;38:e230-2.  Back to cited text no. 1
    
2.Shakuntala P, Praveen S, Shankaranand B, Rajshekar K, Umadevi K, Bafna U. A rare case of plasmacytoma of the ovary: A case report and literature review. Ecancermedicalscience 2013;7:288.  Back to cited text no. 2
    
3.Emery JD, Kennedy AW, Tubbs RR, Castellani WJ, Hussein MA. Plasmacytoma of the ovary: A case report and literature review. Gynecol Oncol 1999;73:151-4.  Back to cited text no. 3
    
4.Makis W, Ciarallo A, Hickeson M, Lisbona R. Gastric recurrence of a primary colon plasmacytoma: Staging and evaluating response to therapy with 18F-FDG PET/CT. Br J Radiol 2012;85:e4-9.  Back to cited text no. 4
    
5.Dores GM, Landgren O, McGlynn KA, Curtis RE, Linet MS, Devesa SS. Plasmacytoma of bone, extramedullary plasmacytoma, and multiple myeloma: Incidence and survival in the United States, 1992-2004. Br J Haematol 2009;144:86-94.  Back to cited text no. 5
    
6.Schirrmeister H, Buck AK, Bergmann L, Reske SN, Bommer M. Positron emission tomography (PET) for staging of solitary plasmacytoma. Cancer Biother Radiopharm 2003;18:841-5.  Back to cited text no. 6
    
7.Kim PJ, Hicks RJ, Wirth A, Ryan G, Seymour JF, Prince HM, et al. Impact of 18F-fluorodeoxyglucose positron emission tomography before and after definitive radiation therapy in patients with apparently solitary plasmacytoma. Int J Radiat Oncol Biol Phys 2009;74:740-6.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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