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Recurrent colon cancer involving the urinary bladder identified with F-18 FDG PET/CT after forced diuresis.

We present the case of a 66-year-old man with a history of synchronous transverse and sigmoid colon cancer, who had undergone surgery 11 months before a follow-up scan. F-18 FDG PET/CT at that time showed no other abnormality. His serum carcinoembryonic antigen (CEA) level returned to normal after surgery. An elevated serum CEA level during the follow-up and F-18 FDG PET/CT showed a solitary hypermetabolic nodule on the patient’s urinary bladder. Owing to the intense urinary radioactivity, the nodule was difficult to visualize on the early image but was easily seen on the delayed image after forced diuresis. His bladder tumor was surgically excised; it tested positive for adenocarcinoma, consistent with the colon tumor.