Leiomyomas are benign tumors that commonly arise from the uterus. They rarely occur in the nasal cavity. Leiomyomas and leiomyosarcomas are clinically similar and may be difficult to distinguish preoperatively. Although PET has been reported to be useful for evaluating uterine smooth muscle tumors, the use of PET for evaluating sinonasal leiomyoma has not yet been reported. Here, we describe the images of a patient with leiomyoma of the nasal septum in whom intense FDG uptake was noted on PET/CT.
Rationale: Aspergillosis is a rare disease that often occurs in patients with diabetes mellitus or compromised hosts. This study describes a 60-years-old woman with unusual pseudo-malignant paranasal invasive aspergillosis with 18F-fluorodeoxyglucose (18F-FDG) uptake treated by endoscopic sinus surgery. To the best of our knowledge, there are few reported cases of paranasal fungal infection with 18F-FDG uptake. Patients concerns: A 60-years-old woman was presented with headache and nasal obstruction. Diagnoses: Computed tomography (CT) showed a shadow with bone destruction in the sinus cavity and accumulation of 18F-FDG uptake. The patient was diagnosed with a malignant tumor or pseudo-malignant paranasal invasive aspergillosis. Interventions: The patient underwent endoscopic sinus surgery; no neoplastic lesions were detected in the areas with CT shadows. All the observed fungal mass reservoirs were removed. Outcomes: The patient remained hospitalized for 1 week after the surgery with no significant postoperative abnormalities. There was no recurrence of the disease for 6 months, and the patient’s symptoms resolved, indicating a good course of follow-up. Lessons: Invasive aspergillosis should be considered a differential disease when positron emission tomography (PET)/CT scans show FDG uptake, CT shows bone destruction, and T2-weighted MRI scans show a low signal.
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