By E.E Payne

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1. 2A History 26-year-old male who has a history of testicular cancer status post orchiectomy and chemotherapy. He was later further treated with radiation therapy. The patient is being evaluated for residual disease. 1). 3) bilaterally. 5) laterally. The right lower lung lesion is also hypermetabolic. No other lesions in the groin and abdomen are noted. Impression Abnormal whole body 18-FDG PET scintigraphy consistent with multiple sites of metastatic disease as discussed above. 1. 2. 3. 4. 5.

In the left lower pelvis, there is focal hypermetabolism in the soft tissue along the posterior aspect of the posterior column of the left acetabulum. There is also both abnormal hypermetabolic activity in the anterior pillar of the left acetabulum, as well as extension into the obturator internis. This soft tissue extension is also undergoing calcification. The degree of hypermetabolism in the acetabular area and the extent appear somewhat increased, versus the prior exam. Additionally, there are three pulmonary nodular densities visible on the current examination.

2. There is a likely primary tumor site localized to the floor of the mouth on the right. 3. Multiple pleural based nodules not likely representing malignancy. Pearls and Pitfalls • Brain metastases are 10 times more common than primary brain tumor, and can usually be visualized on PET scintigraphy. 1,3,12 Discussion The most common brain tumor in adults is the metastatic brain tumor that accounts for 50% of brain malignancy in adults. More than 50% of the metastases are from lung or breast carcinoma.

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