A malignant birthmark detected by 18 F-FDG PET/CT in a patient with esophageal cancer
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IMAGE OF THE MONTH
A malignant birthmark detected by 18F-FDG PET/CT in a patient with esophageal cancer Lijuan Wang 1
&
Yin Zhang 1
Received: 3 July 2020 / Accepted: 7 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
A 56-year-old man presented to the clinic with a 3-month history of eating obstruction and chest pain. The gastroscope and pathology showed an esophageal cancer (small cell neuroendocrine carcinoma). The patient underwent 18F-FDG PET/CT for evaluating the general condition. The esophageal cancer lesion was revealed with SUVmax of 15.7. Besides, multiple lymphadenectasis were revealed at thorax and abdomen with obvious 18F-FDG concentration (image a and b). These were considered lymphatic metastases. Accidentally, an enormous neoplasm was discovered at the left side of body surface (image a and c) (17.8 × 15.6 × 34.2 cm in size). This neoplasm showed mild 18F-FDG concentration with SUVmax of 2.9. The patient did not complain this lesion in the previous inquiry. The cutaneous metastasis was not common in patients with esophageal cancer. So we conduct a further physical examination, which showed an enormous black nevus with some hair at the corresponding position (image d). The patient explained that he was born with this nevus. The nevus was barely growing up until 5 years ago. It was growing slowly with no pain, no swelling, and no bleeding in recent years, so he did not pay attention to this lesion. To define the nature of these lesions, biopsies of the cutaneous and subskin lesions were taken. The biopsy pathology of the cutaneous lesion revealed melanocytic nevus with malignant transformation and the pathology of the subskin lesion revealed a mass of nevus cells (image e and f).
Giant congenital melanocytic nevus (GCMN) is a rare birthmark. Patients with GCMN face an apparently higher lifetime risk of malignant melanoma than the general population [1–5]. Nevertheless, the patient and his family decided to abandon treatment for the nevus. This case highlighted the significance of PET/CT for general evaluation in patient with malignancy. The 18F-FDG PET/CT may contribute to the differential diagnoses of incidental diffuse cutaneous FDG uptake in patients imaged for unrelated indications.
Compliance with ethical standards Conflict of interest The authors declare that they have no conflict of interest. Informed consent Informed consent was obtained from the patient included in the study.
References 1. 2.
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4. This article is part of the Topical Collection on Image of the month * Yin Zhang [email protected] Lijuan Wang [email protected] 1
Nanfang PET center, Southern Medical University Nanfang Hospital, No.1838 Guangzhou Avenue North, Guangzhou, Guangdong Province, China
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Finstad AC, Kirchhof MG. Skin cancer development in a birthmark. CMAJ. 2019;191:E1082. https://doi.org/10.1503/cmaj.190492. Gonzalez J, Palangio M, Fialkoff CN, Schwartz J, Bisaccia E. Giant congenital melanocytic nevus with a large ulceration at birth: a 5year follow-up. J Am Acad Dermatol. 200
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