Skeletal Muscle Metastases in HCC Revealed by 18F-Choline PET/CT

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Hepatocellular carcinoma (HCC) management requires accurate staging and surveillance.
• Elevated α-fetoprotein (AFP) can indicate HCC recurrence.
• 18F-choline Positron Emission Tomography/Computed Tomography (PET/CT) is an emerging imaging tool.

Observation:

• A 68-year-old woman with a history of treated HCC presented with rapidly rising AFP levels.
• 18F-choline PET/CT was performed for disease assessment.
• The imaging revealed multiple focal uptakes within skeletal muscles.

Findings:

• The observed muscle uptakes on 18F-choline PET/CT were interpreted as potential disease recurrence.
• This finding is atypical for common HCC recurrence patterns.
• Skeletal muscle involvement in HCC recurrence requires careful consideration.

Implications:

• The interpretation of 18F-choline PET/CT findings in HCC requires caution.
• Multidisciplinary team (MDT) discussion is essential for accurate diagnosis and treatment planning.
• Further research may be needed to understand the role of 18F-choline PET/CT in detecting rare HCC recurrence sites.