18FFDG PET/CT in pleural epithelioid hemangioendothelioma

Pleural epithelioid hemangioendothelioma (EHE) is a rare malignancy of vascularendothelial origin with nonspecific symptoms and an unpredictable outcome. Diagnosis of this condition by imaging modalities is challenging, and no standard therapeutic approaches have been established in this regard. In this paper, we described the case of a patient with a lowgrade fever, coughing and chest pain who underwent 18FFDG PET/CT after a positive thorax CT showing multiple bilateral calcified pulmonary nodules and extensive rightsided pleural effusion. Moreover, PET/CT revealed increased tracer uptake on the nodular pleural thickening and one nodule in the upper lobe of the right lung. A diagnostic thoracentesis was performed to obtain the pleural fluid. However, cytology was not diagnostic, and the subsequent thoracotomy with pleural fluid drainage and pleural biopsy was positive for pleural EHE. The study showed also an abundant nonFDGavid pleural effusion in the collapsed right lung. Despite chest tube insertion and partial drainage of the volume, patient’s condition deteriorated, and patient passed away six months after the PET scan.