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Staging an esophageal carcinoma by F-18 fluorodeoxyglucose whole-body positron emission tomography.

A 49-year-old man was evaluated for dysphagia. Double-contrast examination showed esophageal lumen narrowing, and histologic assessment of the endoscopically obtained biopsy specimen revealed esophageal carcinoma. To plan the therapy strategy and stage tumors, CT and F-18 fluorodeoxyglucose whole-body positron emission tomography (PET) were performed. Surprisingly, the PET scan revealed a bone metastasis in the spine (T3), which showed no morphologic correlate on the CT. To clarify this discrepancy, MRI was performed and confirmed a metastasis of the third thoracic vertebrae. Infiltration of the bone marrow occurred with malignant cells but without any morphologic changes of the osseous structure. This case indicates that PET may be important for tumor staging.