# Detection of gastric cancer with implantation metastasis to the inguinal region via 18F-FAPI PET/CT: a case report

## TL;DR

A rare case of gastric cancer spreading to the inguinal area was detected using FAPI PET/CT, leading to successful treatment.

## Contribution

Demonstrates the effectiveness of FAPI PET/CT in detecting implantation metastasis of gastric cancer missed by FDG PET/CT.

## Key findings

- Implantation metastasis was confirmed in the inguinal region via FAPI PET/CT.
- The patient showed a favorable prognosis after timely treatment based on the imaging findings.

## Abstract

Implantation metastasis of gastric cancer to the inguinal area is rarely reported, and a clear diagnosis of such metastasis is hard to make, especially when these cancers are invisible on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging. However, certain types of cancers, such as signet-ring cell carcinoma, are particularly sensitive to fibroblast activation protein inhibitor (FAPI) PET/CT. In this case, a patient with a history of gastric cancer and a gastrectomy 2 years previously suddenly developed serious edema in his right lower limb. With the help of FAPI PET/CT and other laboratory findings, abdominal implantation of his primary gastric cancer to the inguinal region was confirmed. After prompt treatment, the patient had a favorable prognosis.