“Hot Liver” in Hepar Lobatum Carcinomatosum on [18F]FDG PET-CT

A 54-year-old woman underwent [ 18 F] FDG PET/CT for assessment of a voluminous ascites with an infiltrating lesion on the left breast at clinical examination. PET-CT revealed a large left breast lesion with homolateral axillary lymph nodes and a left iliac lytic bone lesion, but also hepatomegaly with diffuse and extensive uptake with brain and renal hypometabolism. The result suggest an hepar lobatum carcinomatosum with sequestration of the radiotracer in the liver with a reduction of the background physiological activity. This "hot liver aspect" means being cautious about the risk of a false-negative lesion at staging.