# 18F-FDG PET/CT Staging of Gastroesophageal Junction Adenocarcinoma With Skeletal Muscle Metastasis: A Case Report

## TL;DR

This case report highlights the use of 18F-FDG PET/CT in staging a rare skeletal muscle metastasis in a patient with gastroesophageal junction adenocarcinoma.

## Contribution

The novelty lies in the rare documentation of skeletal muscle metastasis in GEJ adenocarcinoma detected via 18F-FDG PET/CT.

## Key findings

- 18F-FDG PET/CT identified multiple metastases, including skeletal muscle involvement in a GEJ adenocarcinoma case.
- The case emphasizes the importance of PET/CT in accurately staging advanced upper digestive tract malignancies.
- Literature review suggests PET/CT is valuable for pathologic staging of esophageal and GEJ carcinomas.

## Abstract

Malignancies of the upper digestive tract, including esophageal, gastroesophageal junction (GEJ), and gastric carcinoma, tend to present clinically with advanced pathologic staging. This has led to much debate regarding optimal imaging modalities for the purpose of disease staging.

We present the case of a 54-year-old patient with a history of gastroesophageal reflux disease (GERD), who presented with a Siewert Type III GEJ adenocarcinoma with symptomatic skeletal muscle (SM) metastasis. On 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET/CT), the patient was found to have multiple lymph nodes, bone, and SM metastases. This case report also provides a brief review of the current literature regarding 18F-FDG PET/CT use for esophageal and GEJ carcinoma pathologic staging.