Non Small Cell Lung Carcinoma Contralateral Metastasis

        Female, 63 year old, with a mass on the left lung on chest X-ray. On CT upper lobe tumor and multiple lymphonodes in the mediastinum. There is also a nodule in the lung towards the superior lobe.

            FDG PET-CT showed intense uptake in a big mass in the left upper lobe, with multiple lymphonodes in the left hilum and mediastinum (Coronal slices, left and right images are fusion of PET and CT). Two of them are in the right side, one under the carina with marked glucose metabolism (arrows, in middle and right slices). Study was consistent with non small lung carcinoma with metastasis to the right hilum lung and contralateral mediastinum. Though, the tumor is confined to the thorax, surgery was not performed due to the contralateral involvement. Yellow arrow in the left slice points to a normal larynx and uptake in the phonation muscles.

        Staging at the time of initial diagnosis is powerful when FDG PET-CT is employed, and the final therapy decision is more accurate.
 

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