A 15-year-old boy with autism and swallowing dysfunction presented with a 6-month history of fatigue, intermittent abdominal pain, and weight loss. He later became febrile and had multiple episodes of coffee ground emesis and melena stools. An upper endoscopy showed an esophageal mass, and a subsequent 18F-FDG PET/CT scan confirmed this finding. PET/CT also revealed metastatic disease in local lymph nodes, thus upstaging the patient and indicating poor prognosis. Consideration of these severe results and the patient’s quality of life helped guide decision making in patient management, with the ultimate decision to pursue palliative care.
From the Department of Radiology, British Columbia Children’s Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Received for publication May 31, 2018; revision accepted September 5, 2018.
Conflicts of interest and sources of funding: British Columbia Children’s Hospital Research Childhood Diseases Summer Studentship, University of British Columbia Faculty of Medicine Summer Student Research Program.
Correspondence to: Melissa Cindy Kong, Department of Radiology, British Columbia Children’s Hospital, 4480 Oak St, Vancouver, British Columbia V6H 3N1, Canada. E-mail: firstname.lastname@example.org.