Detection of chronic recurrent lower extremity deep venous thrombosis on fluorine-18 fluorodeoxyglucose positron emission tomography

A 48-year-old woman with a history of a neuroendocrine small cell tumor of the uterus with involvement of the lymph nodes of the right groin underwent abdominal hysterectomy, oophorectomy, and chemotherapy with a good clinical response. A deep venous thrombosis of her right leg first developed 3 months before she was examined in the nuclear medicine department and was anticoagulated successfully. She has had complete resolution of all adenopathy, with mild right thigh firmness without residual swelling or tenderness. Positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG PET) was performed to rule out metastases. No evidence of active neoplastic disease was found, but an area of intense tracer uptake in the right calf was detected, consistent with inflammation from chronic thrombophlebitis. Inflammatory vascular disorders have been detected by FDG PET in the past, and tiffs case report suggests that FDG PET may assume a role in detecting thrombophlebitis.