{"paper_id":"8c64bee2-4ef3-40d0-80c2-f1f494ff5fb2","body_text":"Abstract\nA 47-year-old woman with history of hepatocellular carcinoma was referred for 18F-fluorocholine PET/CT evaluation due to elevated alpha-fetoprotein. The examination showed several peritoneal uptakes and two nodular pelvic foci. Coelioscopic exploration allowed confirmation and resection of multiple peritoneal metastases from hepatocellular carcinoma while pelvic biopsies revealed endometriosis and endosalpingiosis. However, alpha-fetoprotein kept rising: subsequent 18F-fluorodesoxyglucose PET/CT exploration found no pelvic uptake, while 18F-fluorocholine PET/CT revealed intense tracer accumulation in the two pelvic masses corresponding to bilateral ovarian metastases of hepatocellular carcinoma. We highlight the importance of 18F-fluorocholine PET/CT in hepatocellular carcinoma especially in patients with confounding comorbidities such as endometriosis.\nData Availability\nData sharing not applicable to this article as no datasets were generated or analyzed during the current study.\nReferences\nCastilla-Lièvre M-A, Franco D, Gervais P, Kuhnast B, Agostini H, Marthey L, et al. Diagnostic value of combining 11C-choline and 18F-FDG PET/CT in hepatocellular carcinoma. Eur J Nucl Med Mol Imaging. 2016;43:852–9.\nTalbot J-N, Michaud L, Grange J-D, Rosmorduc O, Balogova S. Use of choline PET for studying hepatocellular carcinoma. Clin Transl Imaging. 2014;2:103–13.\nBertagna F, Bertoli M, Bosio G, Biasiotto G, Sadeghi R, Giubbini R, et al. Diagnostic role of radiolabelled choline PET or PET/CT in hepatocellular carcinoma: a systematic review and meta-analysis. Hepatol Int. 2014;8:493–500.\nKatyal S, Oliver JH, Peterson MS, Ferris JV, Carr BS, Baron RL. Extrahepatic metastases of hepatocellular carcinoma. Radiology. 2000;216:698–703.\nOortman EH, Elliott JP. Hepatocellular carcinoma metastatic to the ovary: a case report. Am J Obstet Gynecol. 1983;146:715–7.\nLee JM, Park KM, Lee SY, Choi J, Hwang DW, Lee YJ. Metastasis of hepatocellular carcinoma to the ovary: a case report and review of the literature. Gut Liver. 2011;5:543–7.\nBulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu S, et al. Endometriosis. Endocr Rev. 2019;40:1048–79.\nSetubal A, Maia S, Lowenthal C, Sidiropoulou Z. FDG-PET value in deep endometriosis. Gynecol Surg. 2011;8:305–9.\nFastrez M, Nogarède C, Tondeur M, Sirtaine N, Rozenberg S. Evaluation of 18FDG PET-CT in the diagnosis of endometriosis: a prospective study. Reprod Sci. 2011;18:540–4.\nBalogova S, Daraï E, Noskovicova L, Lukac L, Talbot JN, Montravers F. Interference of known or suspected endometriosis in reporting FDG PET/CT performed in another indication. Clin Nucl Med. 2022;47:305–13.\nSilveira MB, Rodrigues DM, Araújo MR, Santiago MA, Gonçalves NT, Schirmer BGA. 18F-Fluorocholine uptake and positron emission tomography imaging in rat peritoneal endometriosis. Reprod Sci. 2018;25:19–25.\nAuthor information\nAuthors and Affiliations\nContributions\nThe study was designed by Adrien Latgé and Benjamin Leroy-Freschini. Material preparation and data collection were performed by Adrien Latgé, François Faitot and Benjamin Leroy-Freschini. The data analysis was performed by Adrien Latgé, Gerlinde Averous, Anne Gressel and Benjamin Leroy-Freschini. The first draft of the manuscript was written by Adrien Latgé and Benjamin Leroy-Freschini and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\nCorresponding author\nEthics declarations\nConflict of Interest\nAdrien Latgé, Gerlinde Averous, Anne Gressel, François Faitot and Benjamin Leroy-Freschini declare that they have no conflict of interest.\nEthics Approval\nAll procedures performed in the present study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\nConsent for Publication\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nLatgé, A., Averous, G., Gressel, A. et al. Bilateral Ovarian Metastases of Hepatocellular Carcinoma Diagnosed with 18F-Fluorocholine PET/CT in a Patient with Endometriosis. Nucl Med Mol Imaging 57, 251–253 (2023). https://doi.org/10.1007/s13139-023-00796-4\nReceived:\nRevised:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s13139-023-00796-4","source_license":"CC0","license_restricted":false}