Post hospital recovery: February 2008 Archives

CT scan obtained for attenuation correction and localization purposes. images generated from the base of the skull to the proximal thighs.

The patient is S/P gastric pull-up surgery for esophageal carcinoma.

There is an intensely hypermetabolic 1.7 cm focus with an SUV of 11.7 nestled between the pancreas and the clips anterior to the abdominal aorta, inferior to the origin of the celiac axis, indicating a new metastatic lesion. There is also a more poorly defined focus superior to the origin of the celiac axis at the surgical clips at frame 110 with a maximal SUV of 4.4. It is uncertain whether this latter focus represents neoplastic disease or possibly only inflammatory changes.

Within the mediastinum however, there is also a new 1.6 cm intense lesion with a maximal SUV of 9.7. This node, in the right prevascular space anterior to the SVC at frame 73, would also represent distal neoplastic spread.

Elsewhere, there are no other FDG avid lesions to indicate additional potential sites of hypermetabolic neoplasm. Specifically, the lungs, liver and bones are free of FDG avid lesions.

IMPRESSION:

Mediastinal hypermetabolic metastasis. Additional metastatic lesion inferior to the origin of the celiac axis. Inflammatory or neoplastic changes more superiorly as detailed above.