Sub-Diaphragmatic Haemangioma Suspected on F-18 Fdg Pet/Ct Confirmed by Rbc Scintigraphy

A 53-year-old woman presented with left submandibular gland carcinoma. Contrast-enhanced computerized tomography done for staging revealed suspicious metastatic omental deposit adjacent to left hemi-diaphragm apart from primary and cervical nodal metastasis. Staging F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography showed high FDG uptake in the primary and metastatic left cervical lymph nodes. However, no FDG uptake was seen in left sub-diaphragmatic mass. Known vascular malformations sites in the left posterior triangle of the neck and liver hemangiomas also showed no uptake. This pattern of uptake raised a suspicion of multiple vascular malformations. Tc-99 m red blood cell scintigraphy was done which confirmed the nature of subdiaphragmatic lesion as haemangioma.