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Focal Immunotherapy-Induced Pancreatitis Mimicking Metastasis on FDG PET/CT

Das, Jeeban Paul MD; Halpenny, Darragh MD; Do, Richard K. MD, PhD; Ulaner, Gary A. MD, PhD

doi: 10.1097/RLU.0000000000002692
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A 46-year-old man with metastatic lung adenocarcinoma was treated with pembrolizumab. FDG PET/CT was performed after 3 cycles of treatment and revealed a focal region of pancreatic tail enlargement with an SUVmax value of 7. Following treatment with corticosteroids and discontinuation of pembrolizumab, radiological resolution was observed, and a diagnosis of focal immunotherapy-induced pancreatitis was made. A unique spectrum of FDG-avid adverse events can develop in patients treated with immune-checkpoint inhibitors that may mimic metastatic disease. Knowledge of the radiologic features of these potential imaging pitfalls is crucial among those interpreting FDG PET/CT to allow prompt and decisive treatment.

From the Department of Oncologic Imaging, Memorial Sloan Kettering Cancer Centre, New York, NY.

Received for publication April 29, 2019; revision accepted May 17, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Jeeban Paul Das, MD, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065. E-mail:

Online date: July 8, 2019

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