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Unusual PET Images: Metastatic Squamous Cell Carcinoma Srinivas Devarakonda, MD,* Glenn Mills, MD and Binu Nair, MD *Department of Medicine-Feist-Weiller Cancer Center, Louisiana State University Health, Shreveport, Louisiana (E-mail: [email protected]) The authors have no financial or other conflicts of interest to disclose.
FIGURE 1. Intensely FDG avid extensive bone lesions on PET imaging.
A
CASE PRESENTATION
48-year-old white male with a medical history of resected squamous cell carcinoma of the skin (forearm) presented with 20 lb weight loss and left axillary lymphadenopathy. His blood work was remarkable for hypercalcemia of 15 mg/dL, normal parathyroid hormone and an elevated PTH-related peptide. Positron emission tomography/computed tomography showed wide spread intensely [18F]-fluorodeoxyglucose avid lesions in the bones with underlying lytic lesions and axillary
The American Journal of the Medical Sciences
lymph nodes with no other visceral lesions. Biopsy of the axillary lymph node and bone marrow both demonstrated metastatic squamous cell carcinoma. Chemotherapy with cisplatin and Taxotere was initiated, however, he died with multiple organ failure without tumor response to therapy. Metastatic squamous cell carcinoma of the skin is the probable primary tumor origin. This is an unusual presentation of squamous cell carcinoma of the skin, with such intensely FDG avid extensive bone lesions on PET imaging (Figure 1).
Volume 350, Number 1, July 2015
e1
IN THE
MEDICAL SCIENCES
Unusual PET Images: Metastatic Squamous Cell Carcinoma Srinivas Devarakonda, MD,* Glenn Mills, MD and Binu Nair, MD *Department of Medicine-Feist-Weiller Cancer Center, Louisiana State University Health, Shreveport, Louisiana (E-mail: [email protected]) The authors have no financial or other conflicts of interest to disclose.
FIGURE 1. Intensely FDG avid extensive bone lesions on PET imaging.
A
CASE PRESENTATION
48-year-old white male with a medical history of resected squamous cell carcinoma of the skin (forearm) presented with 20 lb weight loss and left axillary lymphadenopathy. His blood work was remarkable for hypercalcemia of 15 mg/dL, normal parathyroid hormone and an elevated PTH-related peptide. Positron emission tomography/computed tomography showed wide spread intensely [18F]-fluorodeoxyglucose avid lesions in the bones with underlying lytic lesions and axillary
The American Journal of the Medical Sciences
lymph nodes with no other visceral lesions. Biopsy of the axillary lymph node and bone marrow both demonstrated metastatic squamous cell carcinoma. Chemotherapy with cisplatin and Taxotere was initiated, however, he died with multiple organ failure without tumor response to therapy. Metastatic squamous cell carcinoma of the skin is the probable primary tumor origin. This is an unusual presentation of squamous cell carcinoma of the skin, with such intensely FDG avid extensive bone lesions on PET imaging (Figure 1).
Volume 350, Number 1, July 2015
e1
