Case Report

Diagnosis of Benign Solitary Fibrous Tumors by Positron Emission Tomography

Authors: Mohab Alexander, MD, Stephen Yang, MD, Rex Yung, MD, James Robert Brašić, MD, MPH, Harpreet Pannu, MD

Abstract

An 80-year-old male presented with dyspnea so severe that he could not perform the activities of daily living. Chest radiography and computed tomography of the chest demonstrated a 30-cm left chest mass extending inferiorly to displace the left kidney and spleen. Three incisional biopsies yielded inconclusive results. Positron emission tomography (PET) with fluorodeoxyglucose F 18 (FDG) ruled out malignancy, so a curative excisional biopsy was performed. We conclude that FDG PET is a crucial component of the initial evaluation of patients with solitary pulmonary masses. FDG PET has high sensitivity, specificity, positive predictive value, and negative predictive value in the diagnostic clarification of radiologically indeterminate pulmonary lesions.


Key Points


* The differential diagnosis of a solitary chest mass in senior citizens includes benign and malignant mesothelioma, metastatic tumor, schwannoma, neurofibroma, lipoma, hematoma, mesothelial cyst, empyema, and effusion.


* Positron emission tomography with fluorodeoxyglucose F 18 is a noninvasive technique to stage non-small cell carcinomas of the lung, determine the malignant potential of solitary pulmonary nodules, and is a crucial component of the initial evaluation of patients with solitary pulmonary masses.


* The glycolytic activity of masses can be assessed by means of positron emission tomography with fluorodeoxyglucose F 18 to estimate the likelihood of the presence of a malignant process.

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