18F-FDG-PET imaging of a benign neurofibroma masquerading as metastatic oesophageal carcinoma
- 82 Downloads
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.
KeywordsType 1 neurofibromatosis Neurofibromatosis PET Oesophageal cancer Metastatic oesophageal cancer
We would like to thank Dr Aurora Poon for assisting in the preparation of the figures, and Professor Andrew Scott for editing the manuscript.
- 7.Ferner RE, et al. [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a diagnostic tool for neurofibromatosis 1 (NF1) associated malignant peripheral nerve sheath tumours (MPNSTs): a long-term clinical study. Ann Oncol. 2008;19(2):390–4. doi: 10.1093/annonc/mdm450.CrossRefPubMedGoogle Scholar
- 9.Ferner RE, et al. Evaluation of (18)fluorodeoxyglucose positron emission tomography ((18)FDG PET) in the detection of malignant peripheral nerve sheath tumours arising from within plexiform neurofibromas in neurofibromatosis 1. J Neurol Neurosurg Psychiatry. 2000;68(3):353–7. doi: 10.1136/jnnp.68.3.353.CrossRefPubMedGoogle Scholar