Detection of prostatic glandular adenocarcinoma during staging of non-small-cell lung carcinoma with F-18 FDG PET

The value of F-18 FDG PET for the staging of non-small-cell carcinoma is well established. PET reveals sites of metastatic disease undetected by conventional imaging, and it has the potential for disclosing unrelated pathology. Reported is the case of a 59-year old, with right chest wall pain and a nonproductive cough. A staging whole torso PET revealed an intensely hypermetabolic cavitary right lung mass and a site of intense FDG localization within the floor of the pelvis near the midline of the prostatic base. Subsequent right pneumonectomy and prostatic needle core biopsies yielded histologically different carcinomas of the lung (poorly differentiated non-small-cell) and prostate (extensive adenocarcinoma). The difficulty in differentiating urinary tract pathology from normal urinary activity of FDG is illustrated.