F-18 Fluorodeoxyglucose PET in Fournier Gangrene

Sürücü, Erdem; Canda, Aras Emre; Kaya, Gamze Çapa; Tuna, Burçin; Sengoz, Tark; Yörükoğlu, Kutsal; Terzi, Cem

doi:10.1097/rlu.0b013e3181e4df3e

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…The interesting report about the metabolic evaluation of FG was reported by Surucu et al [3]. They showed the significance of 18 F-fluorodeoxyglucose positron emission tomography for FG in metabolic levels before the visual changes occurred.…”

Section: Discussionmentioning

confidence: 99%

Severe Fournier’s gangrene in a patient with rectal cancer: case report and literature review

et al. 2016

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BackgroundFournier’s gangrene in the setting of rectal cancer is rare. Treatment for Fournier’s gangrene associated with rectal cancer is more complex than other cases of Fournier’s gangrene. We report on a patient with severe Fournier’s gangrene in the setting of locally advanced rectal cancer who was treated with a combined modality therapy.Case presentationA 65-year-old man presented with general fatigue and anal pain. The medical and surgical histories were unremarkable. A black spot on the perineal skin surrounded by erythema was found on physical examination, suspicious for Fournier’s gangrene. Computed tomography scan showed a rectal tumor invading into the bladder (clinically T4bN2M0) and abscess formation with emphysema around the rectum. He was thus diagnosed with locally advanced rectal cancer and Fournier’s gangrene with a severity index score of 12 points. We created a diverting loop colostomy of the transverse colon and performed extensive debridement of the perineum and perianal area. Fifty days later, the patient underwent radical total pelvic exenteration with sacrectomy. In addition, reconstruction of the soft tissue defect was performed using the rectus muscle, the gluteus maximus muscle, and the femoral muscle. Histopathological findings of the specimen were as follows: the tumor was a moderately adenocarcinoma with invasion to the bladder and the prostate (T4b), metastases to four resected lymph nodes (N2), and lymphovascular invasion. There were no major postoperative complications, and the patient was discharged 108 days postoperatively.ConclusionsWe report a rare case of locally invasive rectal cancer associated with Fournier’s gangrene. This case highlights a usual cause of Fournier’s gangrene. Physicians should be cognizant not only of the more common condition but also of the rare presentations including those associated with rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Severe Fournier’s gangrene in a patient with rectal cancer: case report and literature review

et al. 2016

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“…Findings of FG on PET-CT are mentioned in few studies in available published literature [24,25]. The principal role of PET-CT is in tumor staging, treatment planning, and defining tumor response to clinical intervention.…”

Section: Discussionmentioning

confidence: 99%

Early signs of Fournier gangrene: Radiological characteristics

Mp¹,

Yl²,

Jt³

et al. 2018

Radiol Diagn Imaging

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Objective: The goal of this study is to characterize imaging features useful in detecting the early signs of Fournier gangrene (FG). Twenty-seven men and six women, with ages ranging from 31 to 95 years (mean: 61.9) are evaluated. These patients are all documented cases of FG confirmed by blood cultures or pathological specimens. Method:The CT scans of 29 cases, ultrasound scans of 6 cases, and conventional radiography in 6 cases are reviewed in this study. In conclusion, computed tomography (CT) is the most useful modality in identifying early signs of infection such as fat infiltration (p=0.001) and locating the site of infection in the perineum (p=0.014). Result:Positive findings for the diagnosis of FG are fat stranding (n=28; 84%), gas formation (n=27; 81.8%), abscess formation (n=19: 57.5%), and localized fluid accumulation (n=22; 66.6%).Disease foci in the patients included in our study were located in the perineum (n=27; 81.8%), scrotum (n=17; 51.5%), perianal region (n=13; 39.3%), the buttocks (n=16: 48.4%), the pubic region (n=9: 27.2%), and the inguinal region (n=9: 27.2%).The pathogens isolated in these patients were aerobic in 33 subjects (100%) and anaerobic in 10 subjects (30.3%). Mixed florae of 3 different bacteria were observed in 17 subjects (51.5%), of 4 different bacteria in 9 subjects (27.2%), of 5 different bacteria in 4 subjects (12.1%), of 6 different bacteria in 2 subjects (2.6%), and 8 different bacteria in 1 subject (1.3%). Conclusion:Computed tomography (CT) is a helpful imaging modality in establishing early diagnosis of FG by identifying signs of infection such as fat infiltration and disease location in the perineum. Accurate assessment of the extent of disease is also possible and important in prompt and effective planning of treatment.

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“…The interpretation of artifacts, benign causes, and physiologic variants of 18F-FDG imaging is important for tumor staging. It has been reported that several entities mimic malignancy on PET/CT (7,14,15). Infectious diseases can also be evaluated with PET/CT, with a high clinical impact by providing additional diagnostic information (16).…”

Section: Discussionmentioning

confidence: 99%

“…Active granulomatous and infectious disease such as tuberculosis and sarcoidosis, infection or recent instrumentation can cause high FDG uptake in involved areas and lead to confounding results (7,8,9). So, the differential diagnosis of malignancy and infection-inflammations in PET/CT is very important for patient management and for avoiding unnecessary invasive procedures.…”

Section: Introductionmentioning

confidence: 99%

Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

Sürücü¹,

Demir²,

Dülger³

et al. 2016

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A 48-year-old female with complaints of gastrointestinal symptoms such as abdominal pain, fatigue, vomiting, nausea, and weight loss was diagnosed with neuroendocrine tumor after removal of a 2 mm lesion from the stomach with endoscopic biopsy. Her magnetic resonance imaging that was performed due to on-going symptoms showed multiple linear hypointense lesions in the liver. Positron emission tomography/computed tomography (PET/CT) scan was performed for differential diagnosis, which showed high fluorodeoxyglucose (FDG) uptake in these lesions. Clinical and laboratory findings revealed the final diagnosis as Fasciola hepatica. The imaging features of this case is presented to aid in differentiating this infectious disease from malignancy and avoid misdiagnosis on FDG-PET/CT.

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F-18 Fluorodeoxyglucose PET in Fournier Gangrene

Cited by 7 publications

References 9 publications

Severe Fournier’s gangrene in a patient with rectal cancer: case report and literature review

Severe Fournier’s gangrene in a patient with rectal cancer: case report and literature review

Early signs of Fournier gangrene: Radiological characteristics

Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

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