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This case shows an unusual presentation of a melanoma metastasis, visualized by 18F-FDG digital PET/CT, with a single abnormal focal uptake in the right seminal vesicle. Histologic analysis confirmed a melanoma metastasis, subsequently treated by stereotactic radiation therapy. We illustrate an unusual and single-site millimetric melanoma metastasis detected by 18F-FDG PET/CT, highlighting the high performance of state-of-the-art digital PET/CT and the importance of a multidisciplinary approach in treatment and follow-up of melanoma patients. In this case, histological diagnosis was essential for correct diagnosis and adequate clinical management of the patient.

We present images of a 50-year-old man who referred for treatment of a classic Hodgkin lymphoma. While F-FDG PET/CT demonstrated a complete metabolic remission after chemotherapy, an increased F-FDG uptake of a right testicular lesion in F-FDG PET/CT and an unexplained bilateral gynecomastia were observed. A benign Leydig cell tumor was histopathologically proved after a right radical orchiectomy. The serum estradiol level was abnormally elevated reflecting the estrogen-secreting profile. This report highlights that a focal F-FDG uptake in the testicular region with unexplained gynecomastia should suggest the diagnosis of an estrogen-secreting Leydig cell tumor on F-FDG PET/CT.

A partial whole-body PET/CT scan using F-18 FDG was performed for staging in a 62-year-old male smoker with cytologic-proven nonsmall cell lung cancer (NSCLC) of the right upper lobe. PET/CT showed increased FDG accumulation in the primary lung carcinoma, in ipsilateral mediastinal lymph node metastases, and in a solitary metastasis in the left iliac bone. In addition, slightly increased FDG uptake along the periosteum of both femurs was observed. Bone windows on CT showed discrete periosteal reactions. The findings were interpreted as pulmonary hypertrophic osteoarthropathy (PHOA). The diagnosis of PHOA was confirmed clinically by typical digital clubbing and additionally a bone scan was performed. Together with clubbed fingers and toes with eyeglass shape of the nails, neurovegetative disturbances, and dysproteinemia, the disease is also called Pierre-Marie-Bamberger syndrome.