18F-FDG PET/CT Staging of Gastroesophageal Junction Adenocarcinoma With Skeletal Muscle Metastasis: A Case Report.

Malignancies of the upper digestive tract, including esophageal, gastroesophageal junction (GEJ), and gastric carcinoma, tend to present clinically with advanced pathologic staging. This has led to much debate regarding optimal imaging modalities for the purpose of disease staging. We present the case of a 54-year-old patient with a history of gastroesophageal reflux disease (GERD), who presented with a Siewert Type III GEJ adenocarcinoma with symptomatic skeletal muscle (SM) metastasis. On 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET/CT), the patient was found to have multiple lymph nodes, bone, and SM metastases. This case report also provides a brief review of the current literature regarding 18F-FDG PET/CT use for esophageal and GEJ carcinoma pathologic staging.