title: Cutaneous metastatic lung cancer detected with 18F-FDG PET.
abstract: A 48-year-old male smoker presented with a chief complaint of persistent cough for three months. A CT scan revealed only a large right paratracheal mass. The plan was to obtain histological confirmation of suspected lung cancer via bronchoscopy and mediastinoscopy. A whole body 18F-FDG (2-deoxy-2-[18F]fluoro-D-glucose) PET Scan was ordered for staging and localization of the most accessible biopsy site. There was a large, intense hypermetabolic focus corresponding to the paratracheal lesion seen on CT, as well as a lesion in the right adrenal gland. There was also a superficial, subcutaneous hypermetabolic lesion in the mid-back. The subcutaneous lesion, which previously had not been noted, was biopsied and proved to be metastatic adenocarcinoma consistent with the lung primary. This case illustrates the clinical utility of reporting soft tissue abnormalities, which may provide an alternative, more readily accessible location for biopsy that is both safer and less expensive than bronchoscopy or mediastinoscopy.
authors.affiliation: Division Nuclear Medicine, Department of Internal Medicine, St. Louis, Missouri 63110, USA. civelek@slu.edu
authors.forename: A Cahid
authors.initials: AC
authors.lastname: Civelek
authors.forename: Bryan
authors.initials: B
authors.lastname: Piotrowski
authors.forename: Medhat M
authors.initials: MM
authors.lastname: Osman
authors.forename: Esat
authors.initials: E
authors.lastname: Memisoglu
authors.forename: Nael
authors.initials: N
authors.lastname: Khayyat
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Reimers
authors.forename: Keith S
authors.initials: KS
authors.lastname: Naunheim
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D000368:Aged; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18