FDG injection site extravasation: potential pitfall of misinterpretation and missing metastases

Clin Nucl Med. 2012 Nov;37(11):1115-6. doi: 10.1097/RLU.0b013e318266cbdb.

Abstract

18F-FDG PET/CT plays an important role in the management of non-small-cell lung cancers (NSCLC). The treatment options for NSCLC depend upon the initial staging of the disease. The authors report a case with a potential pitfall of overlooking a site of FDG uptake as radiopharmaceutical extravasation at an injection site. The PET/CT demonstrated a T2a N2 bronchial carcinoma, with a solitary focus of FDG uptake at the left antecubital fossa where FDG was administered. Careful interpretation of the images reveals a solitary skeletal metastasis in the left proximal ulna, which makes the disease stage IV rather than IIIA, leading to a significant difference in treatment.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Extravasation of Diagnostic and Therapeutic Materials / diagnostic imaging*
  • Fluorodeoxyglucose F18 / administration & dosage*
  • Humans
  • Injections
  • Lung Neoplasms / diagnostic imaging
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Neoplasm Metastasis / diagnostic imaging*
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Fluorodeoxyglucose F18