The objective of this study was to evaluate the role of PET/CT in diagnosing and evaluating patients with suspected gynaecological tumour recurrence and persistent disease following treatment. This cross-sectional study involving 26 patients with gynaecological malignancies was carried out at Hospital Sultanah Bahiyah between 2006 and 2008. The standard imaging modalities disclosed possible tumour recurrence or persistent disease in 24 of the 26 patients (92.3%). Two patients with negative CT were subjected to PET/CT due to persistently elevated serum tumour markers. PET/CT confirmed tumour recurrence in 9 (34.6%) patients and was inconclusive in 2 (7.7%) patients. No abnormal uptake was observed in 15 (57.7%) patients. Of the 9 patients with positive PET/CT, 7 (77.8%) had a repeat PET/CT and 2 (22.2%) had a CT following subsequent treatment which confirmed no further evidence of disease. Patients with negative or inconclusive PET/CT were either continued with routine follow-up or had a close monitoring by either CT or serum tumour markers. With the availability of PET/CT, almost two-third of patients did not have to undergo unnecessary chemotherapy or radiotherapy. Integrated PET/CT imaging offers beneficial effects in both diagnosing and evaluating suspected tumour recurrence and persistent disease in gynaecological malignancies.
A 20 year-old woman presented with features of a twisted ovarian cyst and had an emergency laparotomy Intraoperative findings revealed bilateral, solid ovarian tumors and a left oophorectomy with biopsy of the contralateral ovary performed. Histopathology report confirmed Burkitt lymphoma of ovary. There was no other evidence of lymphoma elsewhere. The primary Burkitt lymphoma of the ovaries was successfully managed with six courses of highly toxic chemotherapy (Berlin-Frankfurt- Munster 1986 protocol). The patient has remained disease free for the last 36 months.