ABSTRACT
Internal herniation may be seen more frequently in patients with intra-abdominal surgery and malignancy history. We presented a 58-year-old male patient diagnosed with rectal adenocarcinoma seven years ago with a history of surgery and pelvic radiotherapy. When the abdominal computed tomography (CT) image was taken during routine oncology follow-up, a lesion mimicking a serosal implant on the anterior abdominal wall was detected. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging was performed the suspicion of recurrence. It was concluded that the lesion, which was evaluated as an implant in abdominal CT with 18F-FDG PET/CT imaging, was a spontaneously reducing internal herniation. 18F-FDG PET/CT imaging in cancer patients is crucial in illuminating the suspicion of recurrent lesions in these patients and sheds light on the course of the patients in oncology practice.
Keywords:
Internal hernia, mimicking implant, 18F-FDG PET/CT, rectal adenocarcinoma
References
1Ghahremani GG. Abdominal and pelvic hernias. In: Gore RM, Levine MS (eds). Textbook of gastrointestinal radiology, 2nd ed. Philadelphia, PA: Saunders 2000; 1993-2009.
2Liu PH, Kung WC, Wu YC, Chien ST, Chang WY, Hsu CW. Metastatic malignant gastrointestinal stromal tumor mimicking a right incarcerated inguinal hernia. Formosan Journal of Surgery 2014;47:189-192.
3Doishita S, Takeshita T, Uchima Y, Kawasaki M, Shimono T, Yamashita A, Sugimoto M, Ninoi T, Shima H, Miki Y. Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics 2016;36:88-106.
4Hamimi AAH, Yunus TE. Internal mimics hernias and their mimics: how would radiologists help? Egypt J Radiol Nucl Med 2014;45:1071-1078.
5Panagiotidis E, Datseris IE, Exarhos D, Skilakaki M, Skoura E, Bamias A. High incidence of peritoneal implants in recurrence of intra-abdominal cancer revealed by 18F-FDG PET/CT in patients with increased tumor markers and negative findings on conventional imaging. Nucl Med Commun 2012;33:431-438.
6Elekonawo FMK, Starremans B, Laurens ST, Bremers AJA, de Wilt JHW, Heijmen L, de Geus-Oei LF. Can [18F]F-FDG PET/CT be used to assess the pre-operative extent of peritoneal carcinomatosis in patients with colorectal cancer? Abdom Radiol (NY) 2020;45:301-306.
7Li Y, Behr S. Acute Findings on FDG PET/CT: key imaging features and how to differentiate them from malignancy. Curr Radiol Rep 2020;8:22.