• Qianqian Chen, Peiqi Wang, Xiao Zhang, and Jinhe Zhang.
• Guangzhou University of Chinese Medicine, Guangzhou, China.
• Medicine (Baltimore). 2023 May 19; 102 (20): e33802e33802.

RationaleNeoplasms with perivascular epithelioid cell differentiation (PEComas) are mesenchymal tumors that rarely occur in the colon. Here, we report the occurrence of a malignant PEcoma in the colon using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).Patient ConcernsA 55-year-old woman was admitted to the hospital with abdominal pain for 10 days and a self-induced abdominal mass for 3 days. 18F-FDG PET/CT imaging showed a large hypermetabolic nodule and mass in the right mid-upper abdomen with heterogeneous density and a further increase in metabolism on the delayed scan.DiagnosesPEComa of the colon.InterventionsTumor resection was performed.OutcomesThe patient is well after 2 months of treatment, pending further follow-up.LessonsMalignant perivascular epithelioid cell tumors originating in the colon are extremely rare, and our report suggests that PEComa should be considered as a differential diagnosis for 18F-FDG gastrointestinal malignancies. Additionally, 18F-FDG PET/CT may play a key role in the staging and extent of lesions in intestinal malignancies.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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