A case report describes a thoracic aortic dissection incidentally detected on non-contrast PET/CT during evaluation for suspected multiple myeloma; the FDG-avid lesion was initially mistaken for an esophageal mass, showing that aortic dissection is prone to misdiagnosis or being overlooked without contrast agents.
Thoracic aortic dissection was incidentally detected on an initial PET/CT performed for further evaluation of suspected multiple myeloma.
The FDG-avid lesion associated with the aortic dissection was initially mistaken for an esophageal mass.
Identifying and diagnosing aortic dissection on PET/CT remains challenging when contrast agents are not used.
This case report describes a patient who underwent a PET/CT scan to investigate suspected multiple myeloma, a blood cancer. The scan incidentally showed a thoracic aortic dissection, a tear in the wall of the main artery leaving the heart. The abnormal area took up the imaging tracer (FDG) and was at first thought to be a mass in the esophagus. Doctors considered that it could be a myeloma-related tumor outside the bone marrow or a primary esophageal cancer. The report highlights that aortic dissection can be hard to recognize on PET/CT when no contrast dye is used, and it can be misdiagnosed or overlooked, especially when the scan is being done for a different purpose. This research suggests that radiologists and nuclear medicine physicians may need to keep aortic dissection in mind when they see an unexpected FDG-avid area near the esophagus or aorta. As a single case report, it cannot show how often this happens or establish guidelines, but it illustrates a potential diagnostic pitfall.
Han J, Zhang L, Yang F. (2026). Aortic Dissection Incidentally Detected on PET/CT During Evaluation for Suspected Multiple Myeloma.. Clinical nuclear medicine. https://doi.org/10.1097/RLU.0000000000006701