Synchronous primary neoplasms detected on 18F-FDG PET in staging of patients with esophageal cancer.
Because of improvements in diagnostic technology, the incidental detection of synchronous primary tumors during the preoperative work-up of patients with esophageal cancer has increased. The aim of this study was to determine the rate and clinical relevance of synchronous neoplasms seen on (18)F-FDG PET in staging of esophageal cancer.


METHODS
From January 1996 to July 2004, 366 patients with biopsy-proven malignancy of the esophagus underwent (18)F-FDG PET for initial staging. This series of patients was retrospectively reviewed for the detection of synchronous primary neoplasms.


RESULTS
Twenty synchronous primary neoplasms (5.5%) were identified in 366 patients. Eleven neoplasms were in the colorectum, 5 in the kidney, 2 in the thyroid gland, 1 in the lung, and 1 in the gingiva. One of the thyroid lesions and the lung lesion were erroneously interpreted as metastases, leading to incorrect upstaging of the esophageal tumor.


CONCLUSIONS
(18)F-FDG PET detected unexpected synchronous primary neoplasms in 5.5% of patients with esophageal cancer. Sites of pathologic (18)F-FDG uptake should be confirmed by dedicated additional investigations before treatment, because synchronous neoplasms may mimic metastases.
van Westreenen
Henderik L
HL
Department of Surgery, University of Groningen and University Medical Center Groningen, The Netherlands.
Westerterp
Marinke
M
Jager
Pieter L
PL
van Dullemen
Hendrik M
HM
Sloof
Gerrit W
GW
Comans
Emile F I
EF
van Lanschot
J Jan B
JJ
Wiggers
Theo
T
Plukker
John Th M
JT
D000368:Aged; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000379:methods* / Q000706:statistics & numerical data*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18