Clinical Nuclear Medicine vol:35 issue:5 pages:355-356
A 56-year-old man with cT3N1M0 esophageal spinocellular epithelioma underwent FDG-PET/CT 4 and 8 months after chemoradiation because of progressive dysphagia. The initial FDG-PET/CT solely revealed the hypermetabolic tumor and a small adjacent lymph node at the upper thoracic esophagus. The second FDG-PET/CT showed slightly increased paramediastinal FDG-uptake due to inflammation. The third FDG-PET/CT showed a hypermetabolic focus at the thoracic esophagus (local recurrence), the left vocal cord, and in the paramediastinal area. The latter was consistent with chemoradiation-induced changes. This case illustrates that inflammatory changes after chemoradiation may take a long time to develop or subside and have to be appropriately recognized.