A 61-year-old man attended for a 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT); he underwent a CT scan with contrast medium 2 days before, which showed numerous peritoneal nodules. He also had high levels of alpha-fetoprotein (500 mg/ml, normal < 20 mg/ml). 18F-FDG PET/CT showed an extended peritoneal involvement (Fig. 1a,b, and c); multiple pulmonary bilateral nodules and abdominal lymph nodes also had high levels of FDG uptake (Fig. 1d). Maximum standard uptake value (SUVmax) of the peritoneal lesions was 19.2. No clear primary could be found; in particular, no isolated uptakes in gastrointestinal tract could be detected, and pulmonary nodules were bilateral and small.