Pulmonary artery and femoral vein tumour thromboembolism in a patient with osteogenic sarcoma demonstrated by FDG PET/CT

Excerpt

FDG PET/CT is frequently used in staging and restaging of sarcomas. A 35-year-old man who had undergone an above-the-knee amputation for an osteosarcoma of the right tibia presented with localized swelling and progressive dyspnoea while on follow up. The MIP image (a) from a restaging PET/CT study revealed linear tracer uptake (arrow) in the right thigh along with hypermetabolic branching foci in the chest. A contrast-enhanced CT scan of the chest (b) revealed nonocclusive branching intraluminal filling defects (arrow) in both pulmonary arteries. The fusion PET/CT image (c) showed moderate to high-grade FDG uptake (SUV 7.8) corresponding to the linear filling defects in the pulmonary arteries (arrow) suggesting the diagnosis of pulmonary tumour emboli. The linear uptake in the thigh was confirmed by ultrasonography as a deep femoral vein thrombus.

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