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We present here a case of primitive neuroectodermal tumor (PNET) who initially presented with involvement of the right 3 rd rib and underwent neoadjuvant chemotherapy, rib excision, and adjuvant chemoradiotherapy and later underwent posterolateral thoracotomy, pleural nodule excision, and the right 11 h rib metastatic lesion excision. Follow-up 18 F-FDG PET/CT/computed tomography revealed unilateral brown fat suppression in the form of decreased metabolic uptake in the ipsilateral cervical, axillary, and paravertebral brown fat as compared to metabolically active contralateral brown fat, likely due to paravertebral sympathetic chain damage.

Unilateral Brown Fat Suppression on FDG PET/CT-detecting Sympathetic Denervation