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FDG-PET imaging for chronic expanding hematoma in pelvis with massive bone destruction

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Abstract

Chronic expanding hematoma is a rare presentation of a hematoma characterized by a persistent increase in size for more than a month after the initial hemorrhage. We present a 65-year-old man with a chronic expanding hematoma in his ilium who was receiving anticoagulant treatment. The patient had a delayed manifestation of a femoral neuropathy with massive bone destruction. 2-Deoxy-[18F]fluoro-d-glucose (FDG) positron emission tomography (PET) imaging revealed an increased uptake in the rim of the mass in images acquired 1 h after FDG injection. FDG-PET scans were performed using a dedicated PET scanner (HeadtomeV/SET2400 W, Shimadzu, Kyoto, Japan), and the PET data for the most metabolically active region of interest (ROI) were analyzed. The maximum standardized uptake value (SUVmax) was set to a cut-off point of 3.0 to distinguish between benign and malignant lesions. The SUVmax of the patient’s lesion was 3.10, suggesting a malignant lesion. The characteristics of FDG-PET images of chronic expanding hematomas, including the uptake of FDG in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall in mimicking a sarcoma.

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Acknowledgements

The authors thank Mr. Y. Nakamura and the staff of the Department of Nuclear Medicine and the Cyclotron staff of Osaka University Medical School Hospital for their technical support in performing the studies, as well as Ms. M. Sudo and K. Tsunoda for their administrative assistance.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Kenichiro Hamada, Ichiro Higuchi & Jun Hatazawa

  2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Kenichiro Hamada, Akira Myoui, Takafumi Ueda, Noriyuki Tamai & Hideki Yoshikawa

  3. Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Atsuo Inoue

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  1. Kenichiro Hamada
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  2. Akira Myoui
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  3. Takafumi Ueda
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  4. Ichiro Higuchi
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  5. Atsuo Inoue
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  6. Noriyuki Tamai
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  7. Hideki Yoshikawa
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  8. Jun Hatazawa
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Correspondence to Kenichiro Hamada.

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Hamada, K., Myoui, A., Ueda, T. et al. FDG-PET imaging for chronic expanding hematoma in pelvis with massive bone destruction. Skeletal Radiol 34, 807–811 (2005). https://doi.org/10.1007/s00256-005-0895-x

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  • DOI: https://doi.org/10.1007/s00256-005-0895-x

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