Limitations of ۱۸F-FDG PET/CT in Detecting Direct Bronchial Metastasis from Esophageal Squamous Cell Carcinoma: A case report.

Esophageal cancers predominantly metastasize through direct invasion, lymphatic dissemination, or hematogenous spread. Frequent metastatic locations comprise the liver, lymph nodes, lungs, and bones. However, direct bronchial metastases are extremely rare and present significant diagnostic challenges. We report the case of a ۵۰-year-old male diagnosed with esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiotherapy followed by esophagectomy with gastric pull-up reconstruction. Two years after surgery, routine follow-up imaging revealed a suspicious endobronchial lesion. On ۱۸F-FDG PET/CT, the lesion demonstrated only mild uptake, potentially leading to underestimation of its malignant potential. Subsequent bronchoscopy and histopathological examination confirmed metastatic squamous cell carcinoma, consistent with the patient’s primary esophageal tumor. This unusual presentation highlights the limitations of relying solely on metabolic imaging in rare metastatic patterns. It further underscores the importance of a multimodal diagnostic strategy, integrating clinical evaluation, radiological findings, endoscopy, and tissue biopsy to achieve accurate diagnosis and guide optimal management in complex cases.

کلیدواژه ها:

۱۸F-FDG PET/CT ، Bronchial Metastasis ، Esophageal squamous cell carcinoma