18F-FDG PET/CT appearance of metastatic brachial plexopathy involving epidural space from breast carcinoma.

: Patient is a 74-year-old woman with a history of breast carcinoma and known metastatic brachial plexopathy and pulmonary and mediastinal nodal involvement. She had bilateral mastectomies 5 years ago and is currently on chemotherapy. A 6-month follow-up PET/CT study demonstrated no significant interval change in intensity of the previously evident hypermetabolic activity of the brachial plexopathy. However, this activity has extended superiorly and medially involving the right lateral aspect of the epidural space at the C5-6 level, consistent with epidural involvement. In addition, the hypermetabolic activity of the pulmonary and mediastinal metastases has also increased, consistent with interval progression of the disease.