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What Causes Linear Mass Having Increased PET Uptake?
Question: Quick history .
Malignant melanoma diagnosed Feb 2014. One in neck ( left side ) and in left big toe both stage 1. Papillary Thyroid carcinoma April 2014 left side Total Thyroidectomy but still waiting for more info on this from my surgeon. Pap Carcinoma discovered by PET scan with high intensity. Same PET scan showed increased uptake in mediastinum near aortic archwith a 1cm linear mass. My surgical oncologist said he was concerned re Thyroid because of the intense uptake but not the mediastinum one because it was just intense and linear in shape.
My family has a strong history of lung cancer and my father died bery quickly from small cell lung cancer.
I know the standard answer for this type of question is nothing can be determined without seeing scans/reports or biopsies etc however do you know of any reason to be concerned with a linear mass that would show an increased PET uptake ?
I do not smoke, prior to the melanoma surgeries I exercised five times a week and do not have a cough.
Malignant melanoma diagnosed Feb 2014. One in neck ( left side ) and in left big toe both stage 1. Papillary Thyroid carcinoma April 2014 left side Total Thyroidectomy but still waiting for more info on this from my surgeon. Pap Carcinoma discovered by PET scan with high intensity. Same PET scan showed increased uptake in mediastinum near aortic archwith a 1cm linear mass. My surgical oncologist said he was concerned re Thyroid because of the intense uptake but not the mediastinum one because it was just intense and linear in shape.
My family has a strong history of lung cancer and my father died bery quickly from small cell lung cancer.
I know the standard answer for this type of question is nothing can be determined without seeing scans/reports or biopsies etc however do you know of any reason to be concerned with a linear mass that would show an increased PET uptake ?
I do not smoke, prior to the melanoma surgeries I exercised five times a week and do not have a cough.
Brief Answer:
Chance of metastasis is very high here.
Detailed Answer:
Hi
Thanks for query.
I understand your concern.
In all probability that linear mass having increased PET uptake is because of metastasis either from thyroid cancer or from treated melanoma. Both melanoma and thyroid carcinoma have a high rate of hemtological spread and thus may present with metastasis and melanoma has a chance of metachronous metastasis i.e. metastasis may be evident even after fully treated primary cancer long year ago. In this situation you may undergo EBUS (endo-bronchial ultrasound) guided biopsy from that mass or VATS guided biopsy to know the nature of the mass. But to be XXXXXXX chance of metastasis is very high in your condition.
Do consult a thoracic surgeon and go for biopsy as soon as possible to have your diagnosis.
If you have further queries you can write back to me.
Thank you.
Regards,
Dr Arnab Maji
MBBS. MD
Consultant Pulmonologist
Chance of metastasis is very high here.
Detailed Answer:
Hi
Thanks for query.
I understand your concern.
In all probability that linear mass having increased PET uptake is because of metastasis either from thyroid cancer or from treated melanoma. Both melanoma and thyroid carcinoma have a high rate of hemtological spread and thus may present with metastasis and melanoma has a chance of metachronous metastasis i.e. metastasis may be evident even after fully treated primary cancer long year ago. In this situation you may undergo EBUS (endo-bronchial ultrasound) guided biopsy from that mass or VATS guided biopsy to know the nature of the mass. But to be XXXXXXX chance of metastasis is very high in your condition.
Do consult a thoracic surgeon and go for biopsy as soon as possible to have your diagnosis.
If you have further queries you can write back to me.
Thank you.
Regards,
Dr Arnab Maji
MBBS. MD
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you ! It is a big concern to me , I just didnt want to be seen to be dramatic.
I would appreciate having some information behind me when I try and get a dr to refer me to a Thoracic surgeon .
Does it matter that is says linear mass ? My surgical oncologist who dealt with the melanoma said not to worry BECAUSE it was linear but he isnt a lung or chest guy. As you are can you tell me anything on that ?
He also said it was ' just ' an increased uptake on the PET and so not worth investigating. Do thorac mets show up as increased intake on the PET
I would appreciate having some information behind me when I try and get a dr to refer me to a Thoracic surgeon .
Does it matter that is says linear mass ? My surgical oncologist who dealt with the melanoma said not to worry BECAUSE it was linear but he isnt a lung or chest guy. As you are can you tell me anything on that ?
He also said it was ' just ' an increased uptake on the PET and so not worth investigating. Do thorac mets show up as increased intake on the PET
Brief Answer:
Please go through the discussion below
Detailed Answer:
Hello
Thanks for writing back.
Shape of the mass is not important rather size is the important. What was the radiologist's interpretation ? Have you had a contrast enhanced CT (CECT) scan of thorax. If not then kindly go for a CECT scan thorax. It may be an enlarged mediastinal lymphnode because of occult metastasis. Nowadays PET-CT scan. the two modalities are combined in a single machine for best evaluation of anatomical abnormality. As you have history of cancer in the past and family history of lung cancer it will be wise to have a detailed mediastinal investigation.
If you are satisfied with my reply you can write a review for me. If you have further queries you can ask me.
Thank you.
Regards,
Dr Arnab Maji
Please go through the discussion below
Detailed Answer:
Hello
Thanks for writing back.
Shape of the mass is not important rather size is the important. What was the radiologist's interpretation ? Have you had a contrast enhanced CT (CECT) scan of thorax. If not then kindly go for a CECT scan thorax. It may be an enlarged mediastinal lymphnode because of occult metastasis. Nowadays PET-CT scan. the two modalities are combined in a single machine for best evaluation of anatomical abnormality. As you have history of cancer in the past and family history of lung cancer it will be wise to have a detailed mediastinal investigation.
If you are satisfied with my reply you can write a review for me. If you have further queries you can ask me.
Thank you.
Regards,
Dr Arnab Maji
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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