18F-FDG PET/CT uptake in COVID-19: case report of a patient with lung metastases after treatment of nasal cavity malignancy

Background: In high COVID-19 prevalence region, COVID-19 disease may be incidental found in non-specific symptoms or asymptomatic patient with history of tumor who underwent 18 F-FDG-PET/CT for standard oncologic indications. Case presentation: A 51-year-old woman with a 4-year history of adenoid cystic carcinoma of nasal cavity underwent 18 F-FDG PET/CT for restaging during COVID-19 outbreak in Wuhan. Pneumonia lesions were characterized by 18F-FDG uptake ground-glass opacities (GGOs) and multifocal high 18F-FDG-avid patchy consolidation, and without lymph node involvement and pleural effusion. Furthermore, multiple 18F-FDG-positive lung and lumbar metastases were observed. Finally, a diagnosis of COVID-19 was made based on a positive real-time fluorescent polymerase chain reaction (RT-PCR) test of SARS-CoV-2 nucleic acid. Conclusion: The non-specific symptoms or asymptomatic cancer patients presenting 18F - FDG-positive GGOs and patchy consolidation lesions in lung may favor COVID-19, who should be quickly SARS-CoV-2 nucleic acid tested and monitored.