Metastatic Esophageal Adenocarcinoma Presenting as Neck Dermal Metastasis

Figure 3

PET/CT scan and MRI of the patient. PET/CT scanning was performed following the intravenous administration of F-18 FDG and intravenous and enteric contrast. F-18 emission and CT attenuation acquisitions were performed, utilizing diagnostic-quality CT. CT FINDINGS: no masses or areas of abnormal enhancement are identified in the head and neck region. No lymphadenopathy is identified. PET FINDINGS: there is hypermetabolic activity in the lower esophagus and GE junction. While this is likely physiologic or inflammatory activity, malignancy is not excluded. MRI results demonstrate extensive expansile infiltrative process representing known metastatic disease involving the right neck and shoulder musculature, particularly the sternocleidomastoid, anterior scalene, and levator scapulae.