title: Synchronous primary neoplasms detected on 18F-FDG PET in staging of patients with esophageal cancer.
abstract: 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.
authors.affiliation: Department of Surgery, University of Groningen and University Medical Center Groningen, The Netherlands.
authors.forename: Henderik L
authors.initials: HL
authors.lastname: van Westreenen
authors.forename: Marinke
authors.initials: M
authors.lastname: Westerterp
authors.forename: Pieter L
authors.initials: PL
authors.lastname: Jager
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: van Dullemen
authors.forename: Gerrit W
authors.initials: GW
authors.lastname: Sloof
authors.forename: Emile F I
authors.initials: EF
authors.lastname: Comans
authors.forename: J Jan B
authors.initials: JJ
authors.lastname: van Lanschot
authors.forename: Theo
authors.initials: T
authors.lastname: Wiggers
authors.forename: John Th M
authors.initials: JT
authors.lastname: Plukker
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18