August 2020 · Volume 9 · Issue 8 Page 3480 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Agrawal N et al. Int J Reprod Contracept Obstet Gynecol. 2020 Aug;9(8):3480-3482 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Imaging resemblance but diagnostic disparity in cervix cancer: a rare case report Namita Agrawal 1 *, Tarun Kumar Jain 2 , Abhishek Charan 3 , Sanjay Sharma 4 , Hemant Malhotra 3 , Nitin Khuteta 4 , Ajay Yadav 3 INTRODUCTION Uterine cervix cancer is fourth most frequently diagnosed malignancy and leading cause of cancer death in women. 1 International Federation of Gynecology and Obstetrics (FIGO) has described cervical cancer staging from stage I, which is non-invasive, to stage IV, in which the carcinoma has extended beyond the true pelvis or has involved the mucosa of the bladder or rectum or spread to distant organ. 2,3 The diagnosed patients are treated with surgery, chemotherapy and radiotherapy either alone or by combination of the two options, according to stage of the disease. 3 To assess the disease burden, non-invasive imaging modalities computed tomography (CT) and magnetic resonance imaging (MRI) have been employed. The major limitation of these modalities is their dependence on morphological size to diagnose pathology and the limited body region that is imaged. 4 The whole body F-18 Fluoro-2-deoxyglucose (F18 FDG) positron emission tomography PET-CT is an imaging modality, which provides combined metabolic and anatomical information and now FDG PET-CT is an integral step for evaluation of patients with diagnosed and suspected malignancy. 1,5 The present case highlights the limitation of the FDG PET-CT in staging. CASE REPORT A 47 year-old-female presented with history of intermittent bleed from vagina since 20 days. There was progressive weight loss and weakness for 3 months. There was no past history of previous surgery, tuberculosis, hepatitis, or any other chronic illness. On per vaginal examination, there was palpable swelling the vagina and cervix. USG abdomen-pelvis revealed mass in the cervix. USG guided biopsy from the cervix lesion revealed squamous cell carcinoma on histopathology. Before scheduling on treatment, whole body F-18 FDG PET-CT was performed for staging. FDG PET-CT showed FDG avid (SUVmax~19.3) heterogeneously ABSTRACT F-18 FDG PET-CT is an establish modality for staging of cervical cancer. The high uptake value in PET with no evidence of necrosis in CECT is generally understood malignant pathology in known cancer patients. A 47 year-old- female with cervix carcinoma underwent staging FDG PET-CT. It showed FDG avid primary lesion in cervix with FDG avid pelvic, retroperitoneal, mediastinal and supraclavicular lymph nodes. USG guided FNA from the supraclavicular lymph node revealed tuberculosis. Now patient scheduled for ATT and chemotherapy. Keywords: Cervix carcinoma, F-18 Fluorodeoxyglucose PET-CT, Metastatic carcinoma, Tuberculosis 1 Department of Gynecology, SDMH, Jaipur, Rajasthan, India 2 Department of Nuclear Medicine, MGMCH, Jaipur, Rajasthan, India 3 Department of Medical Oncology, MGMCH, Jaipur, Rajasthan, India 4 Department of Surgical Oncology, MGMCH, Jaipur, Rajasthan, India Received: 23 May 2020 Accepted: 30 June 2020 *Correspondence: Dr. Namita Agrawal, E-mail: namitaagarwalsms@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203345