An 81-year-old man had a history of bronchogenic adenocarcinoma diagnosed after a computed tomography (CT) guided biopsy. A stage IB disease was assigned by fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT performed for the cancer staging. An incidental finding of ovoid intense FDG activity bulging out the urinary bladder was demonstrated in the dual-time-point scan. After administration of diuretics, the delayed phase scan was taken and the intense FDG activity was still noted. A bladder neoplasm or metastasis was considered initially, but there was no suspicious soft tissue density in the corresponding CT images. On the contrary, there was a bulging fluid-density pouch in the bladder wall and a bladder diverticulum with entrapped radioactive urine was diagnosed.
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