Intense Choline Activity in Renal Cell Carcinoma Without Obvious 18F-FDG Uptake

A 64-year-old man presented pain over the right kidney region for 1 year. Contrast-enhanced MRI showed a sharply demarcated soft-tissue mass in the lower part of the right kidney. This lesion had no obvious uptake of 18F-FDG on PET/CT imaging, and an unexpected hypermetabolic irregularly shaped nodule was noted in the upper lobe of the right lung. 11C-choline PET was further performed to reveal the pathological property of the kidney lesion, and high uptake was noticed. The patient received surgery for the 2 lesions, and the final pathological diagnoses were chromophobe renal cell carcinoma and synchronous lung adenocarcinoma.

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