Hepatic FDG Avidity From a Migrating Gastric Foreign Body: A PET/CT Pitfall

Abstract

A 53-year-old woman presented with epigastric pain. Gastroscopy and abdominal CT suggested a tumorous lesion in the gastric antrum with possible local perforation. 18 F-FDG PET/CT was performed for staging, revealing intense FDG uptake in the gastric antral wall and in segments I and IV of the liver, highly suggestive of primary gastric cancer with hepatic metastases. Surgical exploration, however, discovered an ingested toothpick that had perforated the gastric antrum and migrated into the liver, forming an inflammatory abscess. Pathology confirmed only inflammatory changes, with no evidence of malignancy. This case highlights that an inflammatory focus secondary to a migrating foreign body can mimic metastatic malignancy on 18 F-FDG PET/CT.

Keywords: false positive; foreign body migration; gastric perforation; hepatic abscess; toothpick ingestion.