Ovarian Hyperstimulation and Oocyte Harvesting Prior to Systemic Chemotherapy-A Possible Pitfall in 18F-FDG PET/CT Staging of Oncologic Patients

Clin Nucl Med. 2016 Aug;41(8):e394-6. doi: 10.1097/RLU.0000000000001234.

Abstract

A 33-year-old woman with Hodgkin disease Ann Arbor stage IIA underwent baseline F-FDG PET/CT scanning. The scan showed gross multicystic enlargement of both ovaries and a nodule at the edge of the right ovary with intense FDG uptake (SUVmax = 14.8). Differential diagnosis would include ovarian lymphoma manifestation, endometrioma, and ovarian or pelvic neoplasia. However, chart analysis revealed previous superstimulation with gonadotropins and gonadotropin release hormone antagonist, and transvaginal oocyte retrieval the day before FDG PET/CT. This led to the diagnosis of ovarian hyperstimulation syndrome, with the FDG-avid focus representing a hemorrhagic follicle after transvaginal oocyte retrieval procedure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control*
  • Female
  • Fluorodeoxyglucose F18
  • Hodgkin Disease / diagnostic imaging*
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / pathology
  • Humans
  • Oocyte Retrieval / adverse effects*
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovulation Induction / adverse effects*
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18