Malignant Perivascular Epithelioid Cell Tumor (PEComa) of the Uterus: Serial Imaging With F-18 FDG PET/CT for Surveillance of Recurrence and Evaluation of Response to Therapy

• Published in: Clinical nuclear medicine Vol. 36; no. 4; pp. e16 - e19
• Main Authors: Ciarallo, Anthony, Makis, William, Hickeson, Marc, Derbekyan, Vilma
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-04-2011
• Subjects: Female; Fluorodeoxyglucose F18; Humans; Middle Aged; Perivascular Epithelioid Cell Neoplasms - diagnosis; Perivascular Epithelioid Cell Neoplasms - diagnostic imaging; Perivascular Epithelioid Cell Neoplasms - therapy; Positron-Emission Tomography; Recurrence; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Uterine Neoplasms - diagnosis; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - therapy
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/RLU.0b013e31820ae032

This is a case of a 52-year-old woman who underwent a hysterectomy to treat a large uterine perivascular epithelioid cell tumor. She was followed with serial F-18 FDG PET/CT scans due to positive surgical margins and vascular invasion on pathology. Initial surveillance PET/CT performed 6 months post surgery was negative; however, a second surveillance PET/CT performed 12 months post surgery showed an intensely FDG-avid recurrence in the pelvic surgical site. The patient received local radiotherapy, 2 cycles of taxol and carboplatin, and was placed on imatinib mesylate (Gleevec). A final PET/CT performed 6 months after initiation of therapy showed rapidly disseminating metastatic disease and the patient died 1 month later. This rare report highlights a potentially new utility of F-18 FDG PET/CT for surveillance of recurrence of a malignant uterine perivascular epithelioid cell tumor, as well as for evaluation of response to therapy.