The Eye-Black Sign on 18F-FDG PET/CT in Endometrial Adenocarcinoma Without Prior Systemic Therapy: A Rare Imaging Pitfall.
Fatih Güzel, Mustafa Nacir, Alpay Çetin et al.
✦ AI-curated · Sources linked
Case in brief
A 53-year-old woman with endometrial adenocarcinoma underwent surgical treatment and adjuvant vaginal brachytherapy. Eighteen months post-treatment, a follow-up 18F-FDG PET/CT revealed bilateral symmetric FDG uptake in the lower eyelids, known as the eye-black sign, with a maximum standardized uptake value of 9.7. Biopsy results indicated chronic inflammatory changes, confirming no recurrence of cancer.
What made this case unusual
The eye-black sign is typically associated with patients undergoing systemic therapy, making its appearance in a patient without such treatment noteworthy.
Diagnostic / clinical pearl
Clinicians should be aware that the eye-black sign can occur in patients without prior systemic therapy, highlighting the importance of recognizing this benign imaging pitfall.
Why it matters
Understanding this imaging finding can prevent misinterpretation as a sign of disease recurrence, thereby avoiding unnecessary interventions.