Chan KL, Lord M, McNamara D, Désilets É, Bergeron E. Spilled gallstone mimicking metastasis from cervix cancer on positron emission tomography – computed tomography. World J Obstet Gynecol 2023; 12(2): 11-16 [DOI: 10.5317/wjog.v12.i2.11]
Corresponding Author of This Article
Eric Bergeron, MD, MSc, Surgeon, Department of Surgery, Charles-LeMoyne Hospital, 3120 Boul, Taschereau, Greenfield Park, Quebec, J4V 2H1, Canada. eric.bergeron.med@ssss.gouv.qc.ca
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Obstet Gynecol. Mar 3, 2023; 12(2): 11-16 Published online Mar 3, 2023. doi: 10.5317/wjog.v12.i2.11
Spilled gallstone mimicking metastasis from cervix cancer on positron emission tomography – computed tomography
Kenneth L Chan, Martin Lord, Daniel McNamara, Étienne Désilets, Eric Bergeron
Kenneth L Chan, Department of Gynecology, Charles-LeMoyne Hospital, Greenfield Park J4V2H1, Quebec, Canada
Martin Lord, Daniel McNamara, Department of Medical Imaging, Charles-LeMoyne Hospital, Greenfield Park J4V2H1, Quebec, Canada
Étienne Désilets, Department of Gastroenterology, Charles-LeMoyne Hospital, Greenfield Park J4V2H1, Quebec, Canada
Eric Bergeron, Department of Surgery, Charles-LeMoyne Hospital, Greenfield Park J4V2H1, Quebec, Canada
Author contributions: Chan KL managed the case, provided case presentation and surgical image. Lord M and McNamara D were involved in the provision of study material and reviewed imaging. Bergeron E and Désilets E participated in the writing of the manuscript and provided digestive and surgical expertise, and all authors critically reviewed and approved the final version of the article.
Informed consent statement: Inform consent is provided.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eric Bergeron, MD, MSc, Surgeon, Department of Surgery, Charles-LeMoyne Hospital, 3120 Boul, Taschereau, Greenfield Park, Quebec, J4V 2H1, Canada. eric.bergeron.med@ssss.gouv.qc.ca
Received: June 29, 2022 Peer-review started: June 29, 2022 First decision: August 1, 2022 Revised: September 2, 2022 Accepted: February 17, 2023 Article in press: February 17, 2023 Published online: March 3, 2023 Processing time: 246 Days and 16 Hours
Abstract
BACKGROUND
Spilled gallstones from previous cholecystectomy is not an uncommon situation. It may further mimic neoplastic disease and can be misled by fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography ([18F]FDG PET/CT).
CASE SUMMARY
A 63 year-old patient was diagnosed with a cancer of the cervix. Pretreatment [18F]FDG PET/CT showed a peritoneal lesion suspicious for metastasis. Surgical exploration and histologic examination revealed the lesion to be a spilled gallstone from a previous cholecystectomy.
CONCLUSION
[18F]FDG PET/CT carries pitfalls since benign conditions such as intraperitoneal gallstones may be confused as malignant lesions. This case highlights the importance to be aware of the possible implications of dropped gallstones for the future, minimize its occurrence, and make all efforts to properly evaluate cancer staging, particularly for the cervix cancer.
Core Tip: Proper staging with imaging and fluorine 18 fluorodeoxyglucose position emission tomography with computed tomography ([18F]FDG PET/CT) is primordial for the management of cervical cancer. [18F]FDG PET/CT however carries pitfalls since benign conditions may be confused as malignant lesions. Spilled gallstones from previous cholecystectomy may be misdiagnosed as neoplastic disease with [18F]FDG PET/CT.
