A 51-year-old man presented with recurrent gliosarcoma and increasing cough over the last months. On 18F-FDG PET/CT, solid lung masses with high 18F-FDG uptake were present. A biopsy taken from a lung lesion indicated distant metastases from gliosarcoma. Gliosarcoma, a rare malignant central nervous system tumor, presents with extracranial metastases in only less than 10%. As highlighted by this case, 18F-FDG PET/CT can be used for whole-body staging in patients with metastatic brain tumor. Vice versa, highly 18F-FDG–avid lung lesions in patients with brain tumors should lead to distant metastases as differential diagnosis despite their rare occurrence.
From the *Department of Nuclear Medicine, University Hospital, LMU Munich, Munich
†German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg
‡Department of Neuropathology and Prion Research
§Department of Radiology, University Hospital
∥Department of Neurosurgery, University Hospital, LMU Munich, Munich
¶Institute of Neuropathology
**Department of Pediatric Hematology and Oncology, University Medical Center, Hamburg-Eppendorf
††Research Institute Children's Cancer Center Hamburg, Hamburg, Germany.
Received for publication May 23, 2019; revision accepted July 22, 2019.
Conflicts of interest and sources of funding: none declared.
Authors' Contributions: M.U. and N.L.A.: drafting of the manuscript, PET/CT reading, and conceiving the design. V.R., J.H., and U.S.: neuropathological evaluation, increased intellectual content, and revision of the manuscript. C.C.C.: PET/CT and MRI reading, increased intellectual content, and revision of the manuscript. M.B.: PET/CT reading, increased intellectual content, and revision of the manuscript. N.T., J.C.T., and P.B.: clinical management, increased intellectual content, and revision of the manuscript.
Correspondence to: Marcus Unterrainer, MD, MSc, Department of Nuclear Medicine, LMU, Marchioninistr. 15, 81377 Munich, Germany. E-mail: email@example.com.