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Bleeding Small Intestine Pyogenic Granuloma on 18F-FDG PET/CT

Iravani, Amir, MD*; Law, Andrew, MBBS, FRANZCR*†; Millward, Michael, MBBS, FRACP‡§; Warner, Michael, MBBS, FRACS; Sparrow, Susan, MBBS, FRCPA

doi: 10.1097/RLU.0000000000000929
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A 53-year-old man with metastatic melanoma, in remission, presented with an 8-week history of melena and anemia. Initial investigations including upper and lower gastrointestinal endoscopy, capsule endoscopy, and 99mTc-labeled red blood cell scan did not reveal a source of bleeding. Given the concern over melanoma recurrence, 18F-FDG PET/CT was performed that demonstrated a focus of intense uptake in the small bowel. Uncomplicated surgical resection of the segment of jejunum containing the lesion was performed, after which the patient reported no further gastrointestinal bleeding. Histopathological assessment of the lesion was consistent with pyogenic granuloma.

From the *WA PET Service, Department of Nuclear Medicine, Sir Charles Gairdner Hospital; †Department of Nuclear Medicine, Royal Perth Hospital; ‡University of Western Australia; Departments of §Oncology, ∥General Surgery, and ¶Anatomical Pathology, PathWest, Sir Charles Gairdner Hospital, Perth, Australia.

Received for publication November 13, 2014; revision accepted June 1, 2015.

Institution where work was performed: WA PET Service, Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Australia.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Amir Iravani, MD, WA PET Service, Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Perth, Western Australia, 6009, Australia. E-mail: iravani_amir@yahoo.com.

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