ABSTRACT
We report a case of synchronous multiple primary lung cancer diagnosed by 18F-FDG PET/CT. A 78-year-old man underwent staging FDG PET/CT that demonstrated intense tracer uptake in the primary, and a second lesion with low uptake. Histopathologic evaluation revealed synchronous squamous cell and bronchioloalveolar carcinoma, representing 2 distinct primaries. FDG PET/CT may identify and diagnose synchronous multiple primary lung cancer on the basis of different morphologic and metabolic features of distinct tumor entities. Moreover, pulmonary lesions with low FDG avidity may still represent malignant disease, even in the context of biopsy-proven FDG-avid lung cancer.
Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/diagnostic imaging , Fluorodeoxyglucose F18 , Lung Neoplasms/diagnostic imaging , Multimodal Imaging , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Squamous Cell/diagnostic imaging , Positron-Emission Tomography , Tomography, X-Ray Computed , Adenocarcinoma, Bronchiolo-Alveolar/metabolism , Adenocarcinoma, Bronchiolo-Alveolar/pathology , Aged , Biological Transport , Fluorodeoxyglucose F18/metabolism , Humans , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Male , Neoplasms, Multiple Primary/metabolism , Neoplasms, Multiple Primary/pathology , Neoplasms, Squamous Cell/metabolism , Neoplasms, Squamous Cell/pathologyABSTRACT
We report a rare case of adrenal epithelioid angiosarcoma metastatic to the epicardium diagnosed by F-FDG PET/CT. A 61-year-old man presented with fatigue, unintentional weight loss, night sweats, and elevated inflammatory markers. FDG PET/CT demonstrated intense uptake in a space-occupying lesion in the right adrenal gland and increased uptake in a lesion adjacent to the heart. Histopathologic evaluation revealed an epithelioid angiosarcoma of the right adrenal gland metastatic to the epicardium. FDG PET/CT is a valuable tool for characterization and making the therapeutic decision concerning indeterminate or suspicious adrenal tumors.
