LUNG
HISTORY
65 year old man with recent right lower lobe resection for adenocarcinoma. Patient was initially staged with CT, which showed localized disease to the right lower lobe. Patient had a PET/CT performed just two weeks after a thoracotomy and lobectomy.
PET/CT FINDINGS
Multiple hypermetabolic lesions with no correlative CT abnormalities in the pericardium, posterior segment of the liver, L4 vertebral body and right infrahilar area compatible with malignancy.
TREATMENT / FOLLOW UP
Chemotherapy.
DISCUSSION
This is an unfortunate case of a patient who underwent right lower lobe resection for a primary adenocarcinoma. Two weeks later he was sent to our institution and referred for PET/CT, which showed at least 4 metastatic lesions. Unfortunately, this patient did not have a preop PET/CT which likely would have shown at least one of the metastatic lesions and made the patient a non-operative candidate. Interestingly, all four metastatic lesions could not be seen on the CT portion of the scan. The liver lesion wasn’t well visualized on the CT portion of the exam, even with a good IV contrast-enhanced exam.