FDG-PET imaging in Merkel cell carcinoma - value of head-to-toe scan

A 63-year-old man was diagnosed with metastatic MCC. Preliminary staging PET scan with 18F-FDG was not done at the time of diagnosis. After completion of chemo- and radiotherapy, the patient underwent a CT scan of the area from the maxilla to the ischium; no evidence of disease was noted. Clinically, the patient was considered to be in remission. The CT scan was followed by head-to-toe FDG-PET scanning which revealed foci of metastatic disease in the right mid- thigh and left proximal calf. This case demonstrates the added value of head-to-toe FDG-PET for the detection of distant metastases in MCC.