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Molecular Imaging and Radionuclide Therapy
E-ISSN: 2147-1959
The Utility of 18F-FDG PET/CT in Detecting Multiple Metastases in Papillary Renal Cell Carcinoma
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The Utility of 18F-FDG PET/CT in Detecting Multiple Metastases in Papillary Renal Cell Carcinoma

Mol Imaging Radionucl Ther 2025;34(1):64-65 DOI: 10.4274/mirt.galenos.2024.02259
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Abstract

The diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for primary kidney tumors is limited. Nevertheless, 18F-FDG PET/CT is valuable for staging renal cell carcinoma (RCC) when suspected metastases coexist, as one-third of patients with RCC have distant metastases upon diagnosis. Herein, we present a 53-year-old male patient with extensive 18F-FDG-avid metastatic lesions and an 18F-FDG-avid renal mass, which later revealed RCC.

Keywords: 18F-FDG PET/CT, papillary renal cell carcinoma, metastasis, staging

Figure 1
Figure 1. A 53-year-old male patient with no known comorbidity was admitted to the hospital with complaints of fever, night sweats, and fatigue for the last month. Upon detecting a suspicious mass in the right kidney and lung metastases on contrast-enhanced computed tomography (CT), 18F-florodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT was performed (A) (1,2,3,4). In the PET/CT images, an exophytic localized renal mass in the upper pole of the right kidney exhibited increased 18F-FDG uptake [maximum standardized uptake value (SUVmax): 5.5], which was considered suspicious for renal cell carcinoma (RCC) (B, arrows). In addition, multiple hypermetabolic parenchymal and pleural lesions in bilateral lungs (SUVmax: 11.9) (C, arrows), bilateral adrenal glands (SUVmax: 9.5) (D, arrows), liver parenchyma (SUVmax: 10.0) (D, arrows), peritoneum (SUVmax: 8.7), mesenterium (SUVmax: 13.1), and omentum (SUVmax: 11.1) (E, arrows), multiple bone metastases (SUVmax: 12.1), and soft tissue lesions in subcutaneous tissue and muscles (SUVmax: 14.6) (F, arrows). All lesions that could not be distinguished on CT images were distinguished on PET/CT images. A biopsy of the renal mass revealed papillary RCC (pRCC). A few days later, after pathological diagnosis, the patient was taken to the hospital because of worsening general condition and died in the intensive care unit due to hemodynamic deterioration. pRCC has a better outcome in localized disease than clear cell RCC (ccRCC). However, metastatic pRCC is associated with higher recurrence rates and lower survival than ccRCC (5). Moreover, various studies have reported that a higher SUVmax or presence of metastatic disease indicates shorter survival (6,7,8). Therefore, 18F-FDG PET/CT is an efficient method for staging RCC, primarily for estimating the tumor load of metastatic disease.
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Footnotes

Ethics

Informed Consent: Patient consent was obtained.

Authorship Contributions

Surgical and Medical Practices: M.O., M.Y.K., Concept: M.O., D.H.Ş., Y.Ş., Design: M.O., D.H.Ş., Y.Ş., Data Collection or Processing: M.O., M.Y.K., Analysis or Interpretation: M.O., S.K., Literature Search: M.O., S.K., Writing: M.O.

Conflict of Interest: No conflicts of interest were declared by the authors.

Financial Disclosure: The authors declare that this study has received no financial support.

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