Usefulness of 18F-fluorodeoxyglucose positron emission tomography/computerized tomography in diagnosis and treatment of pelvic recurrence of bladder cancer after radical cystectomy: a case report

A 58-year-old woman visited our hospital with complaints of serious edematous change in the left lower extremity, eleven months after she received total cystectomy and ileal conduit. Although enhanced pelvic computerized tomography (CT) and magnetic resonance imaging (MRI) were repeatedly performed, the pelvic recurrence was not detected. To investigate the presence or absence of pelvic recurrence further, we performed 18F-fluorodeoxyglucose positron emission/computerized tomography (18F-FDG-PET/CT). 18F-FDG-PET/CT clearly demonstrated high uptake by the pelvic lymph node recurrence. We selected radiochemotherapy using a limited irradiation field for the treatment of lymph node recurrence to cure the edema. One month after the treatment, the edema in the left lower extremity was greatly improved. Four months later, 18F-FDG-PET/CT was performed again to evaluate the efficacy of the treatment and reduced uptake of the irradiation field was observed.