18FDG PET/CT is sensitive but not specific for malignancy: two cases of disseminated tuberculosis mimicking metastatic cancer on imaging and clinical presentation

COLLIN, Maxime;Krug, Bruno;Nollevaux, Marie-Cécile;Collette, Fanny;D'Hondt, Lionel;et.al.
(2025) European journal of case reports in internal medicine — Vol. 12, n° 7, p. 5475 (2025)

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Abstract
Introduction: 18Fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT) scan is widely used in the evaluation of suspected tumoral processes. In addition to its oncological applications, it is also employed in the diagnosis and follow-up of various conditions, including multiorgan tuberculosis. Case description: We report a case series of two young patients with exclusive extrapulmonary disseminated tuberculosis that mimicked a neoplastic process both clinically and on 18FDG PET/CT imaging. Initially, both patients were admitted to the oncology unit with a presumed diagnosis of cancer. However, following an exhaustive work-up, a definitive diagnosis of tuberculosis was established via histopathological and microbiological analysis. Conclusion: These cases underscore the importance of considering disseminated tuberculosis as a differential diagnosis during oncologic evaluations, especially in patients from endemic regions, and highlight the potential psychological impact of prematurely labelling a condition as cancer.
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COLLIN, M., Krug, B., Nollevaux, M.-C., Collette, F., Gilliaux, Q., Faugeras, L., & D’Hondt, L. (2025). 18FDG PET/CT is sensitive but not specific for malignancy: two cases of disseminated tuberculosis mimicking metastatic cancer on imaging and clinical presentation. European journal of case reports in internal medicine, 12(7), 5475. https://doi.org/10.12890/2025_005475 (Original work published 2025)