Role of F18 fluorodeoxyglucose positron-emission tomography/computed tomography in the management of Askin's tumor
A 35-year-old male patient was diagnosed with a PNET of the left chest wall for which he was treated with 15 cycles of chemotherapy. As there was progressive swelling in the left chest wall over 5 months, he was referred for restaging with FDG PET/CT. Increased FDG uptake (maximum standardized uptake value [SUVmax 6.7]) was noted in multiple soft-tissue masses arising from the left chest wall [Figure –]. The largest (measuring 17.4 cm × 9.9 cm) in the lower half of the left hemithorax showed photopenic regions suggestive of necrosis. Erosion of the left 10th and 11th ribs was also noted, along with satellite mass lesions. Since, the scan was suggestive of residual disease, the patient was further treated with five more cycles of chemotherapy in view of the residual disease. Two months after the last cycle of chemotherapy, a follow-up PET/CT showed increase in size of the lesions with extrathoracic and intra-abdominal extensions [Figure –]. However, there was no change in the FDG avidity (SUVmax 6.6) indicating metabolically stable disease. The patient expired 3 months later.