Positron emission tomography in a premenopausal asymptomatic woman: a case report of increased ovarian uptake in a benign condition.

Positron emission tomography (PET) use is increasing; however, optimal utilization in gynecologic oncology remains unclear. PET is expensive, has limited anatomic detail, and it may be difficult to differentiate benign ovarian lesions from malignant lesions when PET is used. A 43-year-old female volunteer's PET scan revealed increased uptake in the left ovary. A subsequent extensive evaluation was entirely normal; however, the patient pursued excision with only a corpus luteum on final pathology. There is a dearth of information regarding PET scan ovarian abnormalities in asymptomatic premenopausal patients, as much of the literature focuses on women with a known ovarian lesion or cancer. Our case represents an increasingly common situation: evaluation and management of an asymptomatic woman with a positive PET scan. As more clinicians encounter PET scan abnormalities, it is imperative that the medical literature documents the limitations of this technology, especially in premenopausal women.

Percutaneous transluminal angioplasty of visceral arterial stenoses: results and long-term clinical follow-up.

PURPOSE: To determine the efficacy and safety of percutaneous transluminal angioplasty (PTA) of the visceral arteries. PATIENTS AND METHODS: We retrospectively evaluated the results of PTA performed in 20 visceral arteries in 19 patients (10 men, nine women; mean age, 63 years). Eleven patients had symptoms characteristic of mesenteric ischemia, four had atypical abdominal pain, and four were undergoing prophylactic dilation before undergoing another procedure involving the abdominal aorta. Clinical follow-up was possible in all patients. RESULTS: PTA was technically successful in 15 of 19 patients (79%); among these 15 patients, 12 (80%) did well clinically. Of the seven PTA procedures that were immediate failures, five failed secondary to an occult malignancy or to extrinsic arterial compression by the median arcuate ligament. Ten (83%) of the 12 patients in whom the procedures were immediate clinical successes are still clinically improved at 4-73 months follow-up (mean, 25 months). PTA was successful in only one of the four patients who had symptoms atypical of mesenteric ischemia, but it was successful in 11 of the 15 patients who had symptoms of mesenteric ischemia or who underwent prophylactic dilation. Major complications occurred in three (16%) of the 19 patients. CONCLUSION: PTA of visceral artery stenoses is effective in patients with symptoms of mesenteric ischemia. It is also effective as prophylaxis in patients undergoing additional procedures in the abdominal aorta.