Multiple primary malignant tumors of upper gastrointestinal tract: A novel role of 18F-FDG PET/CT

Figure 1 A 52-year-old man with synchronous multiple esophageal cancers. The first positron emission tomography/computed tomography (PET/CT) images revealed multiple hypermetabolic esophageal lesions and hypermetabolic supraclavicular, mediastinal lymph nodes (arrows in A, C, E). PET/CT imaging guided radiation plan (arrows in B). The second PET/CT images after 50Gy radiation treatment demonstrated shrinkage of lesions and decrease of fluorodeoxyglucose uptake (arrows D, F).

Figure 2 A 56-year-old woman with metachronous gastric cancer after esophageal cancer resection 5 years ago. Positron emission tomography/computed tomography (PET/CT) displayed multi-retroperitoneal lymph node recurrence (arrow in A), which was later verified as esophageal cancer metastasis (squamous cell carcinoma). PET revealed a small lesion at gastric tube, but endoscopy was negative (arrows in A, B, C, D). Third PET/CT showed an enlarged gastric lesion, and endoscopic biopsy verified gastric tube cancer (adenocarcinoma) (arrows in E, F).

Figure 3 A 53-year-old woman with synchronous hypopharynx cancer combined with esophageal cancer. Positron emission tomography/computed tomography (PET/CT) images revealed hypermetabolic hypopharynx and esophageal lesions, and multiple hypermetabolic supraclavicular, mediastinal lymph nodes (arrows in A). PET/CT imaging guided radiation plan (arrows in B). CT and PET/CT fused images showed hypermetabolic hypopharynx and esophageal lesions (arrows in C, D, E, F).