Online Images in the Medical Sciences| Volume 364, ISSUE 4, e4-e5, October 2022

Unilateral vocal cord finding on PET-CT in a small cell lung cancer patient – another cause?

      A 60-year-old man diagnosed with small cell lung cancer, stage IV, presented an excellent response after first line therapy with chemotherapy (6 cycles of carboplatin + etoposid), with thoracic computed tomography showing a significant shrinking of the left hilar mass, pulmonary nodules, and mediastinal adenopathies (Fig. 1A – before; Fig. 1B – after chemotherapy). As he presented with dysphonia, and paralysis of the left vocal cord (VC) was documented with videolaryngoscopy, left recurrent laryngeal nerve (RLN) involvement by lung carcinoma was assumed. To evaluate residual neoplastic disease and consider consolidative thoracic radiotherapy, a positron emission tomography-computed tomography (PET-CT) scan was performed showing residual metabolic activity in mediastinal adenopathies, but also asymmetric hypermetabolism in the right VC (Fig. 1C-1D). Laryngoscopy was repeated and no macroscopic changes nor histopathological signs of neoplastic involvement were found in the right VC.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Heller M.T.
        • et al.
        Superphysiologic FDG uptake in the non-paralyzed vocal cord. Resolution of a false-positive PET result with combined PET-CT imaging.
        Clin Positron Imaging. 2000; 3: 207-211
        • Kamel E.M.
        • et al.
        Recurrent laryngeal nerve palsy in patients with lung cancer: detection with PET-CT image fusion – report of six cases.
        Radiology. 2002; 224: 153-156
        • Komissarova M.
        • et al.
        Spectrum of 18F-FDG PET/CT findings in oncology-related recurrent laryngeal nerve palsy.
        AJR Am J Roentgenol. 2009; 192: 288-294