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Bacillus Calmette-Guerin injections for melanoma immunotherapy: potential for a false-positive PET/CT

Steven M Sogge1, Joseph S Fotos, Mark Tulchinsky

  • 1From the Section of Nuclear Medicine, Department of Radiology, Milton S. Hershey Medical Center, Penn State University, Hershey, PA.

Clinical Nuclear Medicine
|February 13, 2015
PubMed

An 82-year-old woman presented for routine follow-up PET/CT after undergoing local melanoma resection in the left lower leg, isolated limb infusion chemotherapy, and immunomodulation therapy with Bacillus Calmette-Guérin (BCG) vaccine. Symmetric, bilateral, moderately intense FDG avid axillary and inguinal cutaneous nodules were observed that were new from the prior PET-CT. The patient had developed skin lesions at the BCG injection sites several months before the study. The case raises awareness to PET/CT appearance of local inflammatory response to BCG injection, which could be mistaken by an unaware reader for recurrent melanoma.

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