Multifocal Hemorrhagic Choriocarcinoma With Diffuse Pancreatic FDG Uptake on 18F-FDG PET/CT

Choriocarcinoma is a rare and highly malignant trophoblastic tumor. We present a case involving a 30-year-old woman with abdominal pain, hemoptysis, and elevated serum amylase levels. Initial clinical suspicion included acute pancreatitis. Noncontrast and contrast-enhanced CT revealed hemorrhagic and hypervascular lesions in the lungs, pancreas, liver, and kidneys. 18 F-FDG PET/CT showed diffuse pancreatic enlargement with increased FDG uptake (SUV max , 5.3), consistent with malignancy. Histopathology confirmed choriocarcinoma with elevated HCG levels. Following chemotherapy, HCG levels declined, indicating a positive therapeutic response. 18 F-FDG PET/CT effectively detected choriocarcinoma and assessed its systemic involvement.