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FDG PET/CT Images Demonstrating Fournier Gangrene With Bilateral Pelvic Muscle Extension in a Patient With Recurrent Rectosigmoid Cancer

Hsu, Chia-Tien MD*†; Kao, Pan-Fu MD, MSc*†; Huang, Chi-Chou MD, PhD*‡; Huang, Hsin-Hui MD; Lee, Jong-Kang MD, PhD*†

doi: 10.1097/RLU.0b013e3182868077
Interesting Images

A 71-year-old male patient with Parkinsonism was referred for an 18F-FDG PET/CT scan for suspicious recurrence of rectosigmoid adenocarcinoma. The FDG PET/CT scan revealed increased FDG uptakes in the lower pelvic region around the wall of the rectal stump, with extension to the bilateral pelvic sidewalls and the right gluteous minimus muscle. In addition, multiple small air bubbles were noted in the lesions on the attenuation CT images. Fournier gangrene was diagnosed. After treatment with intravenous antibiotics and debridement with sigmoidoscopic irrigation, the patient was discharged and remained uneventful during clinical follow-up for 50 days.

From the *School of Medicine, Chung Shan Medical University, Taichung, Taiwan. †Departments of Nuclear Medicine, ‡Colon and Rectal Surgery and §Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan.

Received for publication June 14, 2012; revision accepted December 29, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Pan-Fu Kao, MD, MSc, Department of Nuclear Medicine, Chung Shan Medical University Hospital, 110, Sec. 1, Jianguo North Road, Taichung 40201, Taiwan. E-mail:;

© 2014 by Lippincott Williams & Wilkins