FDG-avid pulmonary mucous gland adenoma mimicking lung cancer on 18 F-FDG PET/CT: a rare case report and literature review.

Abstract

Background: Pulmonary mucous gland adenoma (MGA) is an exceptionally rare benign tumor. Even with the assistance of 18 F-FDG PET/CT, the accurate diagnosis of MGA as lung cancer remains challenging. Only one case of fluorodeoxyglucose(FDG)-avid pulmonary mucous gland adenoma and two case of low FDG uptake pulmonary mucous gland adenoma have been reported in English literature, while a single case of moderately increased FDG uptake pulmonary mucous gland adenoma has been documented in French literature. To minimize misdiagnosis and select appropriate treatment strategies, it is crucial to comprehensively analyze its 18 F-FDG PET/CT manifestations in conjunction with clinical symptoms and pathological findings.

Case presentation: In our study, we present a case involving a 70-year-old woman with clinical manifestations of persistent cough and sputum with an FDG-avid mucous gland adenoma mimicking lung cancer on 18 F-FDG PET/CT imaging. Ultimately, the patient underwent a potentially unnecessary video-assisted thoracoscopic lobectomy, and the pathological diagnosis was determined to be MGA. The patient was discharged and remained clinically well without any complaints for a period of 6 months.

Conclusions: The use of 18 F-FDG PET/CT lacks specificity in detecting MGA and may lead to misdiagnosis as a lung malignancy. A comprehensive analysis combining clinical manifestations, bronchoscopy findings, imaging results, and pathological findings is essential for accurate identification of pulmonary mucus gland adenoma.