Small bowel metastasis from lung cancer detected on FDG PET/CT

Lung cancer rarely metastasizes to the small bowel, but it can cause severe complications when it does. These include incapacitating abdominal pain, intestinal obstruction, bleeding, and bowel rupture. This case illustrates how a small bowel metastasis can be identified by F-18 fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography. The key to the diagnosis is in precise fusion of abnormal activity on F-18 fluoro-2-deoxy-D-glucose positron emission tomography with bowel wall thickening on the corresponding computed tomography. Differential diagnoses include inflammatory lesions (such as diverticulitis), a second primary, and prominent physiological uptake.