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Indian Journal of Cancer, Vol. 46, No. 4, October-December, 2009, pp. 354-355 Letter To Editor Subcutaneous metastasis in esophageal carcinoma detected by FDG-PET Imaging Kapoor J, Basu S, Menon S Radiation Medicine Centre (BARC), Tata Memorial Hospital, Jerbai Wadia Road, Parel, Bombay - 400 012 Code Number: cn09088 PMID: 19749476 Sir, Subcutaneous metastasis from esophageal carcinoma is a rare entity. There have been very few reports of subcutaneous metastasis arising in the setting of primary esophageal cancer, in the peer review literature. [1],[2],[3] We herein report the case of a 72-year-old male patient, a diagnosed case of poorly differentiated squamous carcinoma of the middle one-third of the esophagus, who was referred for whole body FDG-PET (Fluorodeoxyglucose-positron emission tomography) study for disease evaluation, following a primary surgery done previously. A whole body PET scan was done after injection of 370 MBq (10 mCi) of 18F-Fluorodeoxyglucose (FDG), using a whole-body, full-ring dedicated PET scanner. Images were reconstructed using a standard iterative algorithm (OSEM). Images were reformatted into transaxial, coronal, and sagittal views. A 3-D image was also obtained by overlapping the various planes. The whole body FDG-PET [Figure - 1] demonstrated a focus of intense FDG uptake in the posterior chest wall. This was in addition to a large focus corresponding to the area of recurrent disease and nodal conglomerate in the esophagus and foci in the apex of the right lung, D12 vertebra, and the mediastinal lymph node. On clinical examination there was a 3 x 3 cm firm, mobile, nontender, subcutaneous swelling in the infrascapular region that was clinically discernible on the right posterior chest wall, which corresponded to the focus in the right posterior chest wall. On excision biopsy, the subcutaneous mass proved to be a metastasis from the esophageal carcinoma [Figure - 2]. References
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