Chronic Colitis Mimicking Malignancy on 68Ga-FAPI PET/CT.

Area of Science:

• Oncology
• Radiology
• Gastroenterology

Background:

• Clinical presentation of abdominal pain and diarrhea can mimic malignancy.
• Advanced imaging like CT and PET/CT are crucial in tumor detection.

Observation:

• A 40-year-old male presented with a 2-month history of abdominal pain and diarrhea.
• Abdominal CT revealed cecal wall thickening, raising suspicion for malignancy.
• 68Ga-FAPI PET/CT demonstrated intense tracer uptake in the cecum, further suggesting a malignant tumor.

Findings:

• Pathological examination of a biopsy specimen definitively diagnosed chronic colitis.
• The imaging findings, initially indicative of malignancy, were inconsistent with the final pathological diagnosis.

Implications:

• This case highlights the importance of histopathological confirmation in diagnosing gastrointestinal conditions.
• Fibroblast activation protein (FAPI) targeted PET/CT may show uptake in inflammatory conditions, not exclusively in tumors.
• Differentiating between malignancy and chronic colitis based solely on imaging can be challenging.