Rim 18F-fluorodeoxyglucose uptake of hepatic cavernous hemangioma on positron emission tomography/computed tomography: A case report

doi:10.12998/wjcc.v12.i13.2243

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May 6, 2024 (publication date) through Feb 21, 2026

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. May 6, 2024; 12(13): 2243-2247
Published online May 6, 2024. doi: 10.12998/wjcc.v12.i13.2243

Rim ¹⁸F-fluorodeoxyglucose uptake of hepatic cavernous hemangioma on positron emission tomography/computed tomography: A case report

Yong-An Hu, Ya-Xin Guo, Qi-Feng Huang

Yong-An Hu, Ya-Xin Guo, Qi-Feng Huang, Department of Nuclear Medicine, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, Jinhua 321000, Zhejiang Province, China

Author contributions: All authors were involved in the preparation of this manuscript. Hu YA participated in data collection and wrote the manuscript; Guo YX participated in literature search and wrote the manuscript; Huang QF wrote and revised the manuscript; all authors have read and agreed to the published version of the manuscript.

Supported by Zhejiang Province Public Welfare Technology Application Research Project, No. LGF21H180007.

Informed consent statement: Written informed consent has been obtained from the patient to publish this paper.

Conflict-of-interest statement: All authors declare that they have no conflicts of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Qi-Feng Huang, MD, Doctor, Department of Nuclear Medicine, Jinhua Hospital of Zhejiang University, Jinhua Municipal Central Hospital, No. 365 Renmin East Road, Jinhua 321000, Zhejiang Province, China. 1156225010@qq.com

Received: November 28, 2023
Revised: February 21, 2024
Accepted: April 3, 2024
Published online: May 6, 2024
Processing time: 149 Days and 5.3 Hours

Abstract

BACKGROUND

Peripheral FDG accumulation in a hepatic hemangioma presenting in a patient with prolonged fever is rare. Therefore, clinicians should pay close attention to patients with hepatic mass.

CASE SUMMARY

A 54-year-old woman with a 4-wk history of daily fevers was admitted to our hospital. A whole body ¹⁸F-Fluordesoxyglucose (PET-FDG) positron emission tomography/computed tomography (PET/CT) was performed to elucidate the source of the fever. However, whole body ¹⁸F-FDG PET/CT raised the suspicion of a malignant lesion because of peripheral FDG accumulation (SUVmax 3.5 g/mL) higher than that of the normal liver parenchyma (SUVmax 1.6 g/mL) surrounding a hypoactive area, and no other abnormalities were showed. Subsequently, the patient underwent liver mass resection. Histopathology showed a hepatic cavernous hemangioma with fatty infiltration around the lesion. The fever disappeared four days after surgery and the patient did not present any complications during follow-up.

CONCLUSION

Fatty infiltration in the peripheral parts of hepatic cavernous hemangioma may lead to subacute inflammation which further activate the Kupffer cells. This may cause prolonged fever and peripheral rim FDG accumulation on PET/CT.

Keywords: ¹⁸F-Fluordesoxyglucose positron emission tomography/computed tomography; Hepatocellular carcinoma; Fever; Fatty infiltration; Case report

Core Tip: Most of the hepatic cavernous hemangiomas (HCHs) are small, asymptomatic, and detected incidentally. The typical characteristics of HCHs on computed tomography or magnetic resonance imaging make their diagnosis straightforward. It has been suggested that low uptake of fluorodeoxyglucose could be useful to distinguish between benign hemangioma and malignant liver lesions. However, in the case presented here, a pathologically confirmed hepatic cavernous hemangioma showed a SUVmax (maximum standardized uptake value) in the margin of the lesion which was higher than that of the normal liver parenchyma. Therefore, clinicians should pay close attention to patients with hepatic mass.