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Patient History
This is a 58 year old male patient with adenocarcinoma of the gastro-esophageal junction and gastric cardia. A total of 3 PET-CT scans were performed on the patient within a six month time frame.

First Scan
The first scan was ordered at the initial diagnosis to determine the extent of disease, and to evaluate for metastases.

Esophageal Cancer - 1st Scan

PET-CT Findings of Initial Scan
Hypermetabolism associated with the patient’s biopsy proven adenocarcinoma involving the gastroesophageal junction and gastic cardia (SUV 6.5). There is a single regional lymph node medial to the gastric cardia (SUV 5.9). No other metastatic disease found.

Second Scan
The second scan was imaged post-chemotherapy and radiation therapy to restage extent of disease after therapy and evaluate for surgical appropriateness.

Esophageal Cancer - 2nd Scan

PET/CT PET-CT Findings Post-chemo/radiation Therapy:
Activity in the gastroesophageal junction and gastric cardia has markedly decreased (SUV was 6.5 now 3.7). The lymph node medial to the gastric cardia has also markedly decreased in activity (SUV was 5.9 now 2.8). No new hypermetabolic foci found.

Third Scan
The third scan was imaged following an esophagectomy and partial gastrectomy to evaluate for any recurrent disease.

Esophageal Cancer - 3rd Scan

PET-CT Findings Post-esophagectomy
No new hypermetabolic foci found in the area of the previous site of adenocarcinoma involvement seen prior to surgery. Two foci of hypermetabolic activity present in the right lung suggestive of multifocal pneumonia rather than pulmonary parenchymal metastases.