Unusual cystic lung metastasis

Description 

A 35-year-old woman was recently diagnosed with cervical cancer, confirmed by histology to be squamous cell cancer. A CT of the chest performed as a part of her initial workup did not show any clear evidence of metastasis (figure 1). She underwent chemoradiotherapy with external beam radiotherapy and cisplatin. A positron-emission tomography (PET)-CT of the chest 12 weeks later demonstrated multiple 18F-Fluorodeoxyglucose  (FDG)-avid lung nodules suggestive of disease progression (figure 2). She subsequently received palliative therapy with carboplatin and paclitaxel. A follow-up CT chest 4 months later showed multiple bilateral randomly distributed cystic lesions of different sizes (largest measuring 29 mm) that were not seen on prior imaging (figure 3). These have been diagnosed as metastatic cystic lung disease.

Figure 1

Normal initial CT scan.

Figure 2

Multiple FDG-avid lung nodules on positron - emission tomography-CT.

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