Asymptomatic Isolated Vulvar Metastasis in Old Treated Case of Carcinoma Rectum—Diagnosis and Treatment Response Evaluation by 18F-FDG PET/CT ScanElumalai, Ram Kumar, MBBS; Verma, Ritu, MBBS, DNB; Malik, Dharmender, MBBS, DNB; Belho, Ethel Shangne, MBBS, DRMClinical Nuclear Medicine: March 2019 - Volume 44 - Issue 3 - p e163–e165 doi: 10.1097/RLU.0000000000002434 Interesting Images Abstract Author InformationAuthors Article MetricsMetrics We report a clinically asymptomatic, old treated case of carcinoma rectum, presenting with raised serum carcinoembryonic antigen level, referred for 18F-FDG PET/CT scan for restaging. Whole-body PET/CT scan revealed an isolated FDG-avid lesion in the left labia majora region, which on histopathology was found to be metastasis from carcinoma rectum. Subsequent 18F-FDG PET/CT done after 4 cycles of chemotherapy revealed favorable response to therapy. 18F-FDG PET/CT facilitates the detection of unusual site of metastasis and its subsequent response evaluation in the index case. From the Department of Nuclear Medicine and PET/CT, Mahajan Imaging, Sir Gangaram Hospital, New Delhi, India. Received for publication October 13, 2018; revision accepted November 8, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Dharmender Malik, MBBS, Department of Nuclear Medicine and PET/CT, Mahajan Imaging, Sir Gangaram Hospital, Old Rajinder Nagar, New Delhi 110060, India. E-mail: email@example.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.