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My mom was diagnosed Nov 2018 with vaginal melanoma with metastasis to lymph nodes, been told its mucosal and the most agressive she started Opdivo in feb and continuing unitl last week PET/CT found two spots on the liver,
Doc ( a melanoma specilalist ) says he is confused if it is melanoma or not, He said it could be an infection ( which he doubts as her blood work is normal) or a blood clot.
She has done very well on Nivo and Doc said he planned to stop the nivo if these two new spots woudnt have shown up ( What does that mean ? Would that be a NED status or stable status )
I am still confused that the size of lymph node is same , SUV uptake is same as 6 months ago but biopsy is negative.
Is the nivo working or not , Is her disease progressing with two more spots on the liver ?
Has anyone seen a blod clot on the liver in PET ?
HER PER Results
1. Right axillary node: 0.7 cm in short axis (series 6 image 78) with a maximum SUV of 3.4, previously 0.8 cm in short axis with a maximum SUV of 5.8.
2. Right inguinal node: 1.1 cm in short axis (series 6 image 414) without hypermetabolism, previously 1.1 cm in short axis with a FDG avidity.
3. Left external iliac node: 1.1 cm in short axis (series 6 image 385) with a maximum SUV of 6.5, previously 1.1 cm in short axis with a maximum SUV of 8.2.
4. Right external iliac node: 0.8 cm in short axis (series 6 image 398) with a maximum SUV of 4.6, previously 0.8 cm in short axis with a maximum SUV of 6.1
1. New, peripherally enhancing segment VII hepatic lesion: 1.7 x 1.4 cm (series 6 image 162) with maximum SUV of 11.1, previously not visualized.
2. 1.3 x 1.1 cm hepatic segment 8 (image 174, series 6) segment VIII with peripheral enhancement, though without clear FDG uptake above background
Lymph nodes: Index nodes as described above. Additional hypermetabolic left inguinal lymph node is not significantly changed in size or FDG avidity when compared to prior.
Lungs: No metastases.
Abdominal and pelvic organs: Index lesion as described above.
Bones: No metastases.
Other: No metastases.
Brain: Unremarkable, symmetric, FDG uptake is seen throughout the cortical gray matter, basal ganglia and the cerebellum. No mass effect. While these images appear within normal limits, MRI is recommended to rule out intracranial and/or skull base metastases if clinically indicated.
Abdomen/Pelvis: Colonic diverticulosis without diverticulitis. Otherwise unremarkable.
Musculoskeletal: Otherwise unremarkable.
At least 2 new hepatic lesions with the larger lesion in hepatic segment 7 demonstrating focal FDG uptake, concerning for new hepatic metastasis. Otherwise, no significant interval change in size or FDG avidity of previously indexed lesions as described above.
This study was reviewed by Dr. Spencer Behr of Nuclear Medicine and Abdominal Imaging
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