An extract of the first 250 words of the full text is provided, because this article has no abstract. It has been shown by our group and by others1,2 that increased glucose metabolism in the aortic wall of patients with aneurysms of the abdominal aorta (AAA) can be visualized in vivo by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Interestingly, an increased glucose metabolism in AAA wall was strongly associated with rapid progression or acute symptoms and therefore increased rupture risk. Moreover, the PET signal was correlated with histopathological changes such as activation of MMP-9, collagen, and elastic fibers as well as macrophage infiltration in the AAA wall. (It is well documented by preclinical studies that increased activity of MMP9 facilitates aneurysm rupture). However, the true prognostic value of increased FDG uptake for AAA progression and rupture risk still remains uncertain. To provide clear evidence, surveillance of small AAA by multiple PET scans would be necessary over a long period. However, PET studies are not routinely performed in patients with AAA for practical and ethical reasons and therefore an increase in glucose metabolism in AAA wall was not directly observed until now. Further, it is not clear weather biomechanical conditions of AAA such as peak wall stress or wall displacement are relevant for FDG uptake. In this report, we describe a patient with a malignant melanoma with coincident and initially small infrarenal AAA who was examined by PET/computed tomography (CT) for staging and follow-up. During surveillance, the AAA showed rapid progression associated with strongly increased glucose metabolism. The AAA was repaired and histopathological as well as computed biomechanical properties were analyzed.