Macrophagic Reaction to Sodium Polystyrene Sulfonate Crystals Mimicking Peritoneal Carcinomatosis on 18 F-FDG PET/CT in Rectal Cancer.
case_report · Level V
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- Record sourced from PubMed, PMID 40247458.
- Also identified by DOI 10.1097/RLU.0000000000005917.
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Abstract
A 68-year-old man presented with rectal bleeding 1 year after a highly complicated surgical course for upper rectal cancer. Endoscopic biopsy confirmed a local recurrence at the rectal stump. 18 F-FDG PET/CT showed intense uptake in peritoneal nodules, suggesting peritoneal carcinomatosis. However, exploratory laparoscopy and pathologic analysis identified basophilic crystals consistent with sodium polystyrene sulfonate (Kayexalate) as the cause of a foreign-body granulomatous reaction, with no evidence of tumor recurrence. This case underscores the importance of considering rare causes of peritoneal false-positive PET/CT findings in patients with a history of severe abdominal complications, ensuring accurate diagnosis and appropriate management.
Medical subject headings
- Polystyrenes
- Rectal Neoplasms
- Positron Emission Tomography Computed Tomography
- Fluorodeoxyglucose F18
- Peritoneal Neoplasms