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Single F-18 fluorodeoxyglucose positron emission tomography hypermetabolic focus containing metastatic papillary thyroid cancer within a primary scarring adenocarcinoma lung cancer.

A 64-year-old woman presented with hoarseness, and her workup revealed an RUL mass. FDG PET revealed a corresponding single hypermetabolic focus in the RUL with additional thyroid-hypermetabolic focus. The RUL mass resection revealed a primary lung, moderately differentiated scarring adenocarcinoma. Contained within the RUL mass were multiple foci of metastatic papillary thyroid carcinoma. Subsequent thyroid resection revealed papillary thyroid carcinoma of identical histology. This is a rare report of a single positive FDG PET focus containing metastatic papillary thyroid within a primary lung cancer. This case highlights the necessity of histologic confirmation of FDG PET-positive lesions in subsequent patient management.