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Year : 2017  |  Volume : 32  |  Issue : 1  |  Page : 75-76  

Pleuroperitoneal mesothelioma: A rare entity on 18f-fdg pet/ct


1 Department of Nuclear Medicine, All Institute of Medical Sciences, New Delhi, India
2 Department of Radiodiagnosis, All Institute of Medical Sciences, New Delhi, India

Date of Web Publication17-Jan-2017

Correspondence Address:
Shamim Ahmed Shamim
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.198499

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   Abstract 

Pleuroperitoneal mesothelioma is an extremely rare entity. Only few cases are reported worldwide. We hereby represent a case of pleural mesothelioma referred for F-18-Fluorodeoxyglucose positron emission tomography/computed tomography for response evaluation. Diffuse F-18-Fluorodeoxyglucose avid peritoneal and omental thickening noted which subsequently turned out to be mesothelial involvement on peritoneal biopsy. This case demonstrates the role of F-18-Fluorodeoxyglucose positron emission tomography/computed tomography in detecting other sites of involvement in case of malignant mesothelioma.

Keywords: 18F FDG PET/CT, malignant mesothelioma, pleuroperitoneal mesothelioma


How to cite this article:
Sahoo MK, Mukherjee A, Girish, Parida K, Agarwal KK, Bal C, Tripathi M, Das CJ, Shamim SA. Pleuroperitoneal mesothelioma: A rare entity on 18f-fdg pet/ct. Indian J Nucl Med 2017;32:75-6

How to cite this URL:
Sahoo MK, Mukherjee A, Girish, Parida K, Agarwal KK, Bal C, Tripathi M, Das CJ, Shamim SA. Pleuroperitoneal mesothelioma: A rare entity on 18f-fdg pet/ct. Indian J Nucl Med [serial online] 2017 [cited 2019 Dec 12];32:75-6. Available from: http://www.ijnm.in/text.asp?2017/32/1/75/198499

A 40-year-old-female without any history of occupational asbestos exposure presented with histologically proven malignant pleural mesothelioma. The patient was referred for F-18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to assess disease status following chemotherapy which revealed extensive FDG avid irregular mass like thickening involving right parietal and visceral pleura leading to collapse of the underlying lung [Figure 1]. Along with that FDG avid diffuse peritoneal and omental thickening noted [Figure 1]. Histopathological evaluation of the peritoneal biopsy confirmed presence of peritoneal mesothelioma.
Figure 1: FDG PET/CT revealed extensive FDG avid irregular mass like thickening involving right parietal and visceral pleura leading to collapse of the underlying lung (long arrows). Along with that FDG avid diffuse peritoneal and omental thickening noted (short arrows).

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Malignant mesothelioma is a rare tumor that originates from the cells lining the mesothelial surfaces, including the pleura, peritoneum, pericardium, and tunica vaginalis. The most common subtype of mesothelioma is the pleural form.[1]

Malignant peritoneal mesothelioma accounts for about 12.5% to 25% of malignant mesotheliomas.[2] It usually occurs in middle-aged men who commonly complain of abdominal pain or a feeling of fullness, abdominal distention or increasing abdominal girth, nausea, anorexia, and weight loss.[3] FDG PET/CT has higher sensitivity and specificity in detecting lymph node and distant metastases, thereby helpful in staging.[4] Also higher standardized uptake value in FDG PET/CT is associated with poor prognosis.[5] FDG PET/CT also has higher accuracy for treatment response evaluation in malignant mesothelioma.[6] This case further confirms the role of FDG PET/CT in detecting the extent of the disease by simultaneous detection of pleural and peritoneal lesion since conventional imaging before treatment was negative in detecting peritoneal lesions. So, 18F-FDG-PET/CT is a valuable imaging modality in the evaluation and management of malignant mesothelioma.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Van Meerbeeck JP, Scherpereel A, Surmont VF Baas P. Malignant pleural mesothelioma: the standard of care and challenges for future management. Crit Rev Oncol Hematol 2011;78:92-111.  Back to cited text no. 1
    
2.
Saraya T, Yokoyama T, Ishii H, Tanaka Y, Tsujimoto N, Ogawa Y. et al. A case of malignant peritoneal mesothelioma revealed with limitation of PET-CT in the diagnosis of thoracic metastasis. J Thorac Dis 2013;5:E11-6.  Back to cited text no. 2
    
3.
Nowak AK, Francis RJ, Phillips MJ, Millward MJ, Schaaf AA, Boucek J. A novel prognostic model for malignant mesothelioma incorporating quantitative FDG-PET imaging with clinical parameters. Clin Cancer Res 2010;16:2409-17.  Back to cited text no. 3
    
4.
Hillerdal G. Malignant mesothelioma 1982: review of 4710 published cases. Br J Dis Chest 1983;77:321-43.  Back to cited text no. 4
    
5.
Gerbaudo VH, Mamede M, Trotman-Dickenson B, Hatabu H, Sugarbaker DJ. FDG PET/CT patterns of treatment failure of malignant pleural mesothelioma: relationship to histologic type, treatment algorithm, and survival. Eur J Nucl Med Mol Imaging 2011;38:810-21.  Back to cited text no. 5
    
6.
Domènech-Vilardell A, Rasiej MJ, Taub RN, Ichise M. Clinical utility of 18F-FDG positron emission tomography in malignant peritoneal mesothelioma. Q J Nucl Med Mol Imaging 2016;60:54-61.  Back to cited text no. 6
    


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