Tongue metastasis was the first sign of malignant pleural mesothelioma detected by PET/CT

Excerpt

A 63-year-old man presented with a 3-month history of gradually aggravated dysphasia. Physical examination revealed a grey-white, firm and tender mass in the root of the tongue. ¹⁸F-FDG PET/CT was employed to further assess the lingual lesion. The maximum intensity projection (MIP) image (A) showed abnormally elevated FDG activity in the region of neck (curved arrow) and an additional focus of abnormally increased 18F-FDG activity in the left lower chest (arrow). Transaxial images demonstrated a large focus of increased activity of the neck corresponding to the known lingual lesion with SUVmax 11.2 (curved arrows, B–D). The FDG-avid lesion in the left lower chest corresponded to a large pleural-based soft tissue mass measured approximately 7.3 × 4.0 cm on the CT images, with heterogeneous intense FDG activity and a central photopenic necrosis, SUVmax of 10.0 (arrows, E–G). We obtained additional patient’s history which revealed his exposure to asbestos for approximately 5 years, with no other pulmonary disease or malignancy history. …