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Positive F-18 FDG positron emission tomography in the perineum after anorectal reconstruction.

A 34-year-old woman was referred to the positron emission tomography (PET) center to exclude recurrence 18 months after treatment of a rectal adenocarcinoma. Preoperative radiation therapy had been delivered and surgery had consisted of abdominoperineal resection with coloperineal anastomosis and creation of a neosphincter by means of a double electrostimulated graciloplasty. F-18 fluorodeoxyglucose (FDG) PET showed large hot spots in the deep pelvis, suggesting locoregional recurrence. Coregistration of PET images with computed tomographic (CT) scans clearly showed that areas of increased metabolism corresponded to the muscles used to reconstruct the sphincter, High FDG uptake can be explained by the continuous electrostimulation of the muscles.