Interesting ImagesLhermitte-Duclos Disease Related With Cowden Syndrome Mimicking Metastatic Lung Cancer on FDG PET/CTKesim, Selin MD; Ozguven, Salih MD; Oksuzoglu, Kevser MD; Erdil, Tanju Yusuf MD Author Information From the Department of Nuclear Medicine, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey. Received for publication June 8, 2022; revision accepted July 21, 2022. Conflicts of interest and sources of funding: none declared. Correspondence to: Selin Kesim, MD, Department of Nuclear Medicine, Marmara University Istanbul Pendik Training and Research Hospital, Muhsin Yazicioğlu St, TR-34899, Üstkaynarca, Pendik, Istanbul, Turkey. E-mail: [email protected]. Clinical Nuclear Medicine 48(2):p e99-e100, February 2023. | DOI: 10.1097/RLU.0000000000004382 Buy Metrics Abstract Cowden syndrome is characterized by multiple hamartomatous and neoplastic lesions including Lhermitte-Duclos disease, which is the main criterion for the diagnosis. Herein, we presented a patient with suspected metastatic disease referred to PET/CT, which showed mildly hypermetabolic multinodular thyroid goiter, multiple hamartomatous pulmonary, and breast nodules. Also, intense hypermetabolism was noted on the cerebellar tumor lesion. Lhermitte-Duclos disease was diagnosed based on the characteristic MRI findings, and she was followed up with a diagnosis of Cowden syndrome. Our case indicates that Cowden syndrome should be included as a differential diagnosis of abnormal FDG uptake in the multiple systemic hamartomatous tumors. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.