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Mesenteric Panniculitis Appears as Metastatic Disease on 18F-FDG-PET/CT Scan

Özgül Ekmekçioğlu1, Selim Bakan2, Kerim Sönmezoğlu3

  • 1University of Health Sciences Turkey, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey.

Molecular Imaging and Radionuclide Therapy
|June 30, 2022
PubMed

Insights

Mesenteric panniculitis, a rare inflammation, can mimic cancer on imaging due to high 18-Fluorine-fluorodeoxyglucose (18F-FDG) uptake. This case highlights its appearance in ovarian cancer patients, emphasizing diagnostic challenges.

Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Mesenteric panniculitis is a rare, benign inflammatory condition affecting mesenteric adipose tissue.
  • Its pathogenesis remains largely unknown.
  • Mesenteric panniculitis can exhibit intense 18-Fluorine-fluorodeoxyglucose (18F-FDG) uptake, mimicking malignant tumors or metastatic disease on positron emission tomography/computed tomography (PET/CT) scans.

Purpose of the Study:

  • To report a case of mesenteric panniculitis in a patient with serous ovarian adenocarcinoma.
  • To illustrate the imaging characteristics of mesenteric panniculitis on PET/CT and magnetic resonance imaging (MRI).
  • To discuss the diagnostic challenges posed by 18F-FDG uptake in mesenteric panniculitis.

Main Methods:

  • Case report of a 47-year-old woman with serous ovarian adenocarcinoma.
  • Post-chemotherapy PET/CT imaging demonstrating intense 18F-FDG uptake and hyperdense nodularity in mesenteric fatty tissue.
  • Correlative MRI and clinical follow-up for diagnosis confirmation.

Main Results:

  • The patient presented with findings suggestive of metastatic disease on PET/CT.
  • Serum tumor marker (CA-125) levels were within the normal range.
  • MRI and clinical follow-up confirmed the diagnosis of mesenteric panniculitis, distinct from malignancy.

Conclusions:

  • Mesenteric panniculitis can present with significant 18F-FDG uptake, posing a diagnostic challenge, especially in cancer patients.
  • Multimodality imaging, including MRI, is crucial for differentiating mesenteric panniculitis from malignancy.
  • Clinical correlation and follow-up are essential for accurate diagnosis and management.
Keywords:
Mesenteric panniculitisPET/CTovary carcinoma

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