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Why does the uterus biopsy shows cancer but PET scan is clear?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

During the routine USG, a suspicious issue was found in the uterus, and the doctor advised a biopsy. In the biopsy, carcinoma with FIGO 1 has been mentioned along with polyps. However, the PET scan shows no issue at all. Now, I am confused about how two reports can show different results.

Please suggest, based on the attached report, whether the patient actually has carcinoma or if the report is incorrect. Please suggest how to proceed further and in which way.

Hi,

Welcome to icliniq.com.

I have gone through your query as well as through the reports that you have provided (attachments removed to protect the patient's identity).

Based on this, I can gather that the patient had symptoms of PV (per vaginal) spotting, and evaluation showed an endometrial polyp. Biopsy of which shows endometrioid carcinoma, FIGO grade 1.

A PET (positron emission tomography) scan does not show any abnormalities throughout the body.

This means she definitely has stage I endometrial carcinoma as it is biopsy-proven. A PET scan will only show something if it is a large tumor or if it has spread beyond the endometrium, which in her case is not found.

Both reports are correct. PET will not show cancer if it is in the early stage and it is in specific areas like the gastrointestinal tract or cavity. Plus, her tumor is low grade (grade 1), which again will have less uptake on PET.

I think this would be sufficient to clear your confusion.

I would be happy to help you further if you have any other questions.

Thank you.

Patient's Query

Hi doctor,

Thank you for your response.

It means the patient needs to go for surgery for the removal of the uterus, right?

Hi,

Welcome back to icliniq.com.

Yes, based on the reports, she needs surgery. As per the current investigation, she has stage I disease, and only surgery may be sufficient.

We can be clearer once we get a report after surgery is done.

Ideally, the surgery should be done by an oncologist or a gynecologist who is experienced in cancer surgeries.

I would be happy to help you further if you have any questions.

Thank you.

Medically reviewed byiCliniq medical review team

Published At May 4, 2022
Reviewed AtDecember 15, 2025

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