18F-FDG-PET imaging of a benign neurofibroma masquerading as metastatic oesophageal carcinoma.
We present the case of a 65-year-old male with squamous cell carcinoma of the thoracic oesophagus on a background of neurofibromatosis type 1. On computed tomography, he was noted to have a large left-sided superior mediastinal mass. Initially, this mass was thought to be metastatic lymphadenopathy; however, it did not display fluorodeoxyglucose uptake on positron emission tomography. Subsequent biopsy confirmed the mass to be a neurofibroma and the patient commenced definitive chemo-radiation. Positron emission tomography had a major impact on management since the presumed lymph node disease was not included in the radiation field. In addition, positron emission tomography altered prognostic stratification since lymph node involvement is a poor prognostic factor in oesophageal cancer. We could only identify one other case in the English literature in which positron emission tomography was used to distinguish metastatic carcinoma from a neurofibroma, although there are a number of reports that describe the utility of positron emission tomography in differentiating benign neurofibromas from malignant connective tissue tumours.
Azad
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A
Ludwig Institute Oncology Unit, University of Melbourne, Austin Hospital, Austin Health, Melbourne, VIC, Australia. arun_azad@hotmail.com
Chong
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G
Tauro
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Aly
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Tebbutt
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NC
D000368:Aged; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D009455:Neurofibroma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography
D019788:Fluorodeoxyglucose F18