Open AccessFirst case on fluorodeoxyglucose positron emission tomography/computerized tomography of a distant skip metastases to parotid node from esophageal adenocarcinoma
Author(s) -
Vincenzo Militano,
Sivakumar Muthu,
Naheed Farooq,
Rakesh Sajjan
Publication year - 2018
Publication title -
world journal of nuclear medicine
Language(s) - English
Resource type - Journals
eISSN - 1607-3312
pISSN - 1450-1147
DOI - 10.4103/wjnm.wjnm_82_17
Subject(s) - medicine , esophagus , adenocarcinoma , positron emission tomography , standardized uptake value , radiology , esophagogastroduodenoscopy , metastasis , lymph node , fluorodeoxyglucose , biopsy , carcinoma , pathology , endoscopy , cancer , surgery
We are presenting the first case of a gastro-oesophageal junction adenocarcinoma with metastasis only to the intraparotid lymph node simulating Warthin's tumor. A 66-year-old man underwent an esophagogastroduodenoscopy that found circumferential ulcerated esophageal tumor beginning 40 cm from incisors resulting in stricture and two discrete erosions in the proximal third of esophagus. Biopsies from the stricture have demonstrated a poorly differentiated gastric adenocarcinoma. Computerized tomography (CT) confirmed the site of primary without evidence of distant metastasis. Positron emission tomography/CT showed high uptake in the known carcinoma in distal esophagus involving the gastro-oesophageal junction extending into the cardia of the stomach, the maximum standardized uptake value (SUV max ) 7.4. Furthermore, there was a focus of high-grade tracer activity, SUV max 6.2, in the left intraparotid nodule which was initially thought to represent Warthin's tumor rather than metastasis; there was no evidence to suggest metastases elsewhere. Fine needle aspiration and biopsy from the enlarged intraparotid lymph node revealed that the histology was consistent with a poorly differentiated adenocarcinoma, metastasis from upper gastrointestinal tract.