Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Limitations of 18F-FDG PET/CT in detecting direct bronchial metastasis from esophageal squamous cell carcinoma: A case report

Document Type : Case report

Authors
Thong Huy Mai 1
Chau Quynh Anh 2
Ngo Thi Minh Hanh 3
Bui Quang Bieu 4
Khoa B Tran 1
Le Thi Thu Nga 5
Paola Castellucci 6
Paeng Chul Jin 7
Mai Hong Son 1
1 Department of Nuclear Medicine, 108 Military Central Hospital, Hanoi, Vietnam
2 Faculty of Nuclear Medicine, Hanoi Medical University, Hanoi, Vietnam
3 Department of Histo-pathology, 108 Military Central Hospital, Hanoi, Vietnam
4 Department of Radiation Oncology and Radiosurgery, 108 Military Central Hospital, Hanoi, Vietnam
5 Cancer Institute, 108 Military Central Hospital, Hanoi, Vietnam
6 Service of Nuclear Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
7 Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
10.22038/aojnmb.2025.90754.1662
Abstract
Esophageal cancers predominantly metastasize through direct invasion, lymphatic dissemination, or hematogenous spread. Frequent metastatic locations comprise the liver, lymph nodes, lungs, and bones. However, direct bronchial metastases are extremely rare. We report a case of a 50-year-old male diagnosed with esophageal squamous cell carcinoma who received neoadjuvant chemoradiotherapy and subsequent esophagectomy with gastric pull-up reconstruction. Two years after surgery, follow-up imaging indicated suspicious bronchial lesion. On 18F-FDG PET/CT, the bronchial lesion exhibited only mild 18F-FDG uptake, which may underestimate its malignancy. Histopathological assessment verified metastatic squamous cell carcinoma, congruent with the primary esophageal tumor. This case illustrates the diagnostic limitations of 18F-FDG PET/CT in specific situations and emphasizes the necessity of incorporating clinical, endoscopic, and pathological findings in intricate cases.
Keywords
18F-FDG PET/CT
Bronchial metastasis
Esophageal squamous cell carcinoma
Subjects
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 14, Issue 2
July 2026
Pages 182-186