Multiple Skin Metastases Imaged with FDG PET/CT: The First Clinical Finding of Squamous Cell Lung Carcinoma: Original Image

Abstract

1046ur patient was a 59-year-old man with multiple skin lesions in his scalp. Clinically, lesions were on the frontal and parietal parts of scalp. They were necrotic and ulcerated. Pathological and immunohistochemical (with CEA, EMA, TTF-1) examination of the skin lesions revealed metastases of a squamous cell carcinoma. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) combined with computed tomography (CT) was performed to assess the primary tumor, and the scan demonstrated two intense hypermetabolic cutaneous lesions in the scalp (one was 2.5 cm in size and SUV 4.8; other was 2 cm in size and SUV 3.6) ( Figure 1). In addition, there was a mass obliterating upper lobe bronchus of the right lung (5 x 5 cm in size, SUV 6.5) and multiple ipsilateral mediastinal and hilar hypermetabolic lymph nodes on PET/CT images (Figure 2). The diagnosis of the specimen obtained by bronchoscopic biopsy from the mass was reported as squamous cell carcinoma of the lung.In cases of lung cancer, metastasis to the skin is less common than that to other organs (brain, bones, liver, and adrenal) and the reported incidence ranges from 1 to 12%.