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CASE REPORT article
Front. Oncol.
Sec. Cancer Metabolism
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1555092
Elevated 18F-FDG accumulation in a malignant epithelioid angiomyolipoma: a case report and review of literature
Provisionally accepted
Li Zhang 1
Leqing Chen 2
Yinqian Deng 1 Huanyu Chen 1 Yujun Wu 1 Peng An 3
Fan Jun 4
Dawei Jiang 1
XIAOLI LAN 1 Wei Cao 1*- 1 Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- 2 Department of Radiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- 3 Department of Radiology, Xiangyang First People’s Hospital, Xiangyang, China
- 4 Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
Epithelioid angiomyolipoma (EAML) is a tumor with malignant potential, as evidenced by its pathological features. Further investigation into its additional characteristics, particularly in imaging, is of great significance for non-invasive detection methods to understand its malignant potential. In this context, we present a case study of a 47-year-old male patient with a right renal EAML. The patient underwent nephrectomy but subsequently developed liver metastasis.Next-generation sequencing confirmed mutations of tuberous sclerosis 2 (TSC2) in both the primary and metastatic lesions. Consequently, the patient received maintenance treatment with the mTOR inhibitor, everolimus. However, treatment was discontinued after six months due to disease progression. Subsequent 18 F-FDG PET/CT imaging revealed a large heterogeneous hypermetabolic mass in the liver, along with two other hypermetabolic metastases near the liver capsule. The patients prognosis was poor, with indicators such as TSC2 mutation, tumor necrosis, high Ki-67 expression, and α-SMA-negative fibroblasts. Despite reoperation, the patient still succumbed to disease progression. The occurrence of malignant metastatic EAML detected using 18 F-FDG PET/CT imaging is infrequent. We conducted a comprehensive review of the relevant literature on 18 F-FDG PET/CT imaging for EAML. Notably, this article emphasizes that elevated 18 F-FDG uptake in EAML may serve as a novel indicator of malignant EAML.
Keywords: Epithelioid angiomyolipoma, 18 F-FDG, PET/CT, Smooth muscle actin, mTOR inhibitor
Received: 03 Jan 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 Zhang, Chen, Deng, Chen, Wu, An, Jun, Jiang, LAN and Cao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wei Cao, Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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