Detection of Solitary Humeral Metastasis From Pancreatic Adenocarcinoma With F-18 FDG PET/CT

In this case report, we present the F-18 FDG PET-CT images of an isolated humeral metastasis in a 52-year-old man with locally advanced pancreatic adenocarcinoma. The intense focal uptake in the right proximal humerus was incidentally detected during a routine 6-month follow-up scan after treatment to the primary with gemcitabine chemotherapy and stereotactic radiotherapy. A subsequent MRI scan confirmed a lytic lesion that correlated with the PET-CT abnormality and a CT-guided biopsy demonstrated metastatic adenocarcinoma consistent with a pancreatic primary tumor. FDG PET has been reported to be effective in detecting previous occult sites of disease. Though the incidence of isolated bone metastases from primary gastointestinal malignancies is rare and detection of any type of metastases for pancreatic cancer usually is associated with an extremely poor prognosis, aggressive treatment of symptomatic bone metastases is an important part of the overall management to maximize the quality of life.