Fig. 2

A 62-year-old man diagnosed with MM 14 years previously re-presented with a biopsy proven left lower lobe recurrence (a) and a suspicious enlarged portocaval lymph node (not shown) on a restaging CT. Incidental findings of ‘gallstones’ and ‘hyperdense renal cysts’ were also noted. A subsequent FDG PET-CT revealed multiple sites of markedly FDG-avid disease in the chest, abdomen and pelvis including an intramural gastric cardia metastasis (b), an intraluminal gallbladder metastasis (‘gallstone’) (c) and a 3-mm left renal metastasis (‘hyperdense renal cyst’) (d) as seen on the axial PET images and corresponding axial sections from the prior CECT. This resulted in a change from potential radical surgery to chemotherapy—a major clinical impact