Pseudomyogenic Hemangioendothelioma Distinctive FDG PET/CT Findings With Numerous Multilayer Lesions in a Single Distal Extremity

Pseudomyogenic hemangioendothelioma is a rare vascular tumor described as a fibroma-like variant of epithelioid sarcoma. There were scant publications about FDG PET/CT findings of pseudomyogenic hemangioendothelioma. A 20-year-old man with biopsy-confirmed pseudomyogenic hemangioendothelioma of the left tibia had FDG PET/CT for evaluation of the lesion extent and metastasis, which demonstrated numerous, multilayer FDG-avid lesions of the left lower extremity below the knee. Although pathologic examination is mandatory for diagnosis, FDG PET/CT of the case showed distinctive image finding of pseudomyogenic hemangioendothelioma: multifocal and multilayer lesions in a single distal lower extremity.