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Topic: Cancer
Category: Case report
Case Presentation: A 45-year-old man with stage IIIB non-small cell lung carcinoma (NSCLC) underwent PETCT for post-treatment re-staging. An incidental, false-positive FDG-avid fatty lesion was found in the right gluteal region. Follow-up 18F FDG PET-CT showed partial remission of the right upper lobe lung mass and mediastinal lymphadenopathy, but metastatic lesions progressed in the left upper lobe and T12 vertebra. The prior right gluteal fatty lesion showed altered glucose metabolism with FDG avidity, suspicious for metastasis.
A biopsy of the right gluteal lesion confirmed a hibernoma. The patient was started on the standard doses of the cyclophosphamide, doxorubicin, and etoposide (CAE) regimen (1,000 mg/m2 cyclophosphamide, 60 mg/m2 doxorubicin, and 50 mg/m2 vincristine) for six cycles, at 4-week intervals. The patient opted for conservative treatment with maintenance dose chemotherapy tablets (erlotinib 150 mg once/day).
Conclusions: An appropriate 18F FDG PET-CT characterization of a hibernoma in a patient with NSCLC may avert futile treatment, as it potentially resembles a false-positive malignant lesion.
To cite this article Hassan Mahgoub T. H., Ahmad Saad F. F. Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Serdang, Malaysia , Ramdave S. Department of Nuclear Medicine and PET, Monash Medical Centre, Australia Monash University, Victoria, Australia A gluteal hibernoma masquerades as a metastatic tumor in post-treatment 18F FDG PET-CT WCRJ 2026;
13
: e3016
DOI: 10.32113/wcrj_20263_3016
Submission date: 02 Dec 2025
Revised on: 07 Jan 2026
Accepted on: 25 Feb 2026
Published online: 25 Mar 2026
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