Abstract
An 80-year-old woman who had a history of undergoing left nephrectomy for clear type renal cell carcinoma (RCC) 15 years earlier and no subsequent known recurrence underwent chest CT imaging for an unrelated indication. Two left lower lobe nodules were observed, one of high density and the other of intermediate density. Follow-up PET scan detected increased FDG uptake in the latter nodule, but none in the former. It was likely that the former was metastasis and the other, a benign lesion. Surgical resection of both nodules was performed and histologic evaluation confirmed origination from the same primary renal cell carcinoma.
This rare case of simultaneous nearby metastatic lesions with contrasting qualities on imaging reminds us of the capacities and limitations of CT and PET imaging in the diagnosis of malignancy.
