Multiple Benign Papillomas with Unexpected Uptake on PET Scanning

Capewell N,Ford A,Diep P

doi:10.35248/2155-9554.10.494

Abstract

79 year old lady with newly diagnosed lung adenocarcinoma which was felt to be operable. She underwent a PET/CT which showed localised disease in the lung, but also highlighted several cutaneous lesions. She was referred to dermatology for diagnosis and biopsy to exclude cutaneous deposits of tumour. There was a past history of a previous lung adenocarcinoma excised in 2015. Examination showed several wart-like, papillomatous lesions to the skin, not typical of secondary deposits of tumour. Shave biopsy of a representative lesion was taken and histology showed a benign squamous papilloma. At review in oncology, the remaining lesions had completely resolved a few weeks later. There have been case reports of benign lesions showing unexpected FDG uptake. This case highlights the phenomenon and the need to obtain timely tissue diagnosis to prevent potentially life-saving treatment such as surgery in this case.

Highlights

79 year old lady with newly diagnosed lung adenocarcinoma which was felt to be operable
A 79 year old lady with a history of non-Hodgkin’s Lymphoma and lung adenocarcinoma that had been successfully resected three years previously was diagnosed with a new sub pleural mass during ongoing surveillance via CT scan
Benign Squamous Papillomas are relatively common lesions which arise from the stratified squamous epithelium of the epidermis these may be associated with one of the many Human Papilloma Viruses most frequently HPV-6 and HPV-11

Summary

Introduction

79 year old lady with newly diagnosed lung adenocarcinoma which was felt to be operable. To ensure that there were no undetected metastases, whole body PET scanning was carried out (Figure 1). It was felt that these areas of cutaneous uptake could represent cutaneous metastases which would have given a much poorer prognosis and would have meant that surgical treatment was no longer indicated. The lady was referred urgently to dermatology for review and biopsy.

Results

Conclusion