High-Grade FDG Uptake of Fumarate Hydratase-Deficient Uterine Leiomyoma.

Fumarate hydratase-deficient uterine leiomyoma is a rare, unique subtype of uterine leiomyoma. It may occur sporadically or in the context of the hereditary leiomyomatosis and renal cell carcinoma syndrome. We describe FDG PET/CT findings in a case of fumarate hydratase-deficient uterine leiomyoma. The tumor showed intense FDG uptake with SUV max of 14, which may be due a metabolic shift to aerobic glycolysis of the tumor caused by loss-of-function mutations of fumarate hydratase gene. This case indicates that fumarate hydratase gene mutation may be a possible factor for increased FDG uptake in uterine leiomyomas.