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Esophageal Cancer

History: Recent diagnosis of a long segment of adenocarcinoma of the esophagus.

Impression:

  1. Esophageal carcinoma extending from the carina to the GE junction. There is no PET evidence for local or regional metastases.
  2. Small right external and common iliac lymph nodes which show increased metabolism out of proportion to their size. These could be reacting to prostate or bladder infection. Metastatic disease from carcinoma of the bladder or prostate is another potential explanation. It is not very likely that these represent metastases from the esophageal carcinoma.
     
Clinical Utility:  FDG-PET-CT scan is more accurate than CT (86% vs. 73%; P = 0.0002) in the evaluation of patients with CA esophagus. It provides additional information over CT, impacting on management in 14% of patients (Clin Positron Imaging. 1999 Oct;2(5):255-260 ).