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Pediatric Esophageal Squamous Cell Carcinoma Staged With 18F-FDG PET/CT

Melissa Cindy Kong1, Helen Ruth Nadel

  • 1From the Department of Radiology, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.

Clinical Nuclear Medicine
|October 17, 2018
PubMed

Insights

A teenager with autism experienced unexplained symptoms, leading to the discovery of an esophageal mass. Advanced imaging revealed metastatic disease, necessitating palliative care due to the poor prognosis.

Area of Science:

  • Oncology
  • Pediatric Gastroenterology
  • Nuclear Medicine

Background:

  • Autism spectrum disorder (ASD) and swallowing dysfunction can present with complex gastrointestinal symptoms.
  • Early identification of malignancy in adolescents is crucial for effective management.
  • Gastrointestinal symptoms like fatigue, abdominal pain, and weight loss warrant thorough investigation.

Observation:

  • A 15-year-old male with autism and dysphagia presented with progressive fatigue, abdominal pain, and weight loss.
  • Clinical deterioration included fever, coffee ground emesis, and melena, indicating significant gastrointestinal bleeding.
  • Esophageal mass identified via upper endoscopy.

Findings:

  • ¹⁸F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) confirmed the esophageal mass.
  • FDG PET/CT revealed metastatic disease in regional lymph nodes, indicating advanced-stage cancer.
  • The patient was upstaged due to metastatic spread, signifying a poor prognostic outlook.

Implications:

  • The case highlights the importance of a comprehensive diagnostic approach in patients with ASD and atypical GI symptoms.
  • Advanced imaging like FDG PET/CT is vital for accurate staging of esophageal malignancies.
  • Quality of life and patient-centered care are paramount in managing advanced cancers, guiding decisions toward palliative strategies.

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