PMC9792822_01
Fused FDG-PET-CT scan eighteen months after initial surgery, demonstrates (A) FDG-avid recurrent disease at the border of the mediastinum and left pleura (arrow), and (B) two additional smaller mildly FDG-avid left pleural deposits (arrows). FDG-PET, 18-fluorodeoxyglucose positron emission tomography; CT, computed tomography.
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Eighteen months after surgery, a whole body 18-fluorodeoxyglucose positron emission tomography (FDG-PET)-computed tomography (CT) scan demonstrated FDG-avid recurrent disease (Figure 1A), and two small foci of disease in the pleura with low FDG uptake (Figure 1B).
Contrast enhanced chest CT (soft tissue windows) obtained five months after imaging shown in (A) reveals too numerous to count new bilateral pleural nodules (arrows), consistent with progressive bilateral pleural metastatic disease, and (B) larger volume of pleural metastatic involvement in the right pleura inferiorly (arrow) with no recurrence within the previously irradiated pleura of the left costophrenic recess. CT, computed tomography.
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Four months after the second course of EBRT, a chest CT scan demonstrated multifocal disease progression involving the left and right pleurae, with the appearance of multiple new pleural metastases (Figure 2A,2B).