Unilateral Suppression of Brown Fat on FDG PET/CT in Horner ... : Clinical Nuclear Medicine (original) (raw)

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Ulaner, Gary A. MD, PhD; Samstein, Robert MD; Cahlon, Oren MD; Weber, Wolfgang A. MD; Rimner, Andreas MD

From the Departments of *Radiology and †Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.

Received for publication March 18, 2016; revision accepted May 31, 2016.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Gary A. Ulaner, MD, PhD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Box 77, New York, NY 10065. E-mail: [email protected].

Abstract

A 29-year-old woman underwent resection of a left anterior mediastinal thymoma and pleurectomy. Postsurgical 18FDG PET/CT scan demonstrated FDG avidity in the right neck and upper thoracic fat but relatively absent FDG-avid fat in the left neck and upper thorax. Bilateral FDG-avid fat was also apparent in the lower chest and upper abdomen. After surgery, the patient demonstrated Horner syndrome, with left-sided ptosis, miosis, and facial anhidrosis. It is hypothesized that left-sided sympathetic nerves were compromised during surgery, leading to Horner syndrome and denervation of ipsilateral brown fat. The unilateral FDG avidity should not be mistaken for malignancy.