Perineural Spread of Endometrial Cancer Detected by 18F-FDG PET/CT

We report a rare case of perineural spread from recurrent endometrial cancer detected by positron emission tomography with 18F-FDG-PET/CT. We highlight perineural spread as a potential sole indicator of recurrence, warranting early detection due to its association with poor prognosis and metastatic risk. Although MRI is typically preferred for perineural spread, PET/CT proved critical in this post-treatment setting, revealing recurrence and guiding care. Awareness of PNS in pelvic cancers is essential to avoid delayed diagnosis.