We are reporting the case of a 37-year-old woman with rising beta-human chorionic gonadotropin (HCG) levels over 4 years. Curettage was performed 5 times and diagnostic laparoscopy twice, but no trophoblastic tissue was found. Vaginal ultrasound and power Doppler sonography showed a solid tumor of the anterior uterus wall with high vascularization. 18F-2-deoxy-D-glucose-positron emission tomography (FDG-PET) revealed a single focus of FDG uptake in projection of the uterus. Sonographically, the tumor of the uterus appeared like a leiomyoma. Thus focal FDG uptake was the sole indicator for a malignant trophoblastic tumor. Histological examination of the tumor revealed a choriocarcinoma.
