Multifocal micronodular pneumocyte hyperplasia mimicking lung cancer

Abstract

Abstract Background Tuberous sclerosis complex (TSC) is a disease characterized by systemic hamartomas(1). Multifocal micronodular pneumocyte hyperplasia is a pulmonary manifestation of tuberous sclerosis complex presenting as diffuse multiple small nodules(2). Sclerotic bone lesions are commonly observed in TSC and present as multiple osteosclerotic bone lesions(3). The coexistence of these two benign lesions is easy to misdiagnose as malignant tumors. Case presentation A patient presented with multiple pulmonary ground-glass nodules and osteosclerotic bone lesions found in CT. 18F-FDG PET/CT showed metastatic carcinoma or diffuse lung cancer with multiple bone metastases. She was diagnosed with diffuse lung cancer with multiple bone metastases at first but ultimately confirmed as TSC by genetic sequencing. Conclusions Although 18F-FDG PET/CT is playing an increasingly important role in tumor diagnosis, we still need to take the results dialectically. Doctors from multiple disciplines need to be sensitive to the nonspecific findings of TSC found on imaging, skin manifestations are the most intuitive diagnostic clues to the disease.