Please give opinion on PET Scan

May I get your comment on what the following results show for my father? Opinions, please, on stage, metastasis, possible treatment options and timeframe?  Is surgery viable?  VATS?  He has a brain CT scan scheduled this week.  Thank you very much

76YO Male, colon bisection in 2003 for cancerous polyps and possible lymph node.  CT scan in 7/06 showed no abnormalities.

PET Scan 5/12/09:
FINDINGS:
Skull base and neck: No mass, adenopathy or focal abnormal FDG uptake is identified in the neck. There are moderate degenerative changes in the cervical spine.
Thorax: A central LEFT upper lobe/LEFT hilar mass is again noted, not significantly changed from the recent CT chest dated 5/1/2009. The mass shows markedly abnormal FDG uptake with maximum SUV of 19.2. This is highly suspicious for malignancy. There is a mildly enlarged LEFT hilar lymph node which shows abnormal FDG uptake likely resenting a metastasis. No other sites of abnormal FDG uptake are identified in the chest. Calcified granulomas are noted in the pretracheal and subcarinal regions and as well as the RIGHT hilum. Atherosclerotic calcifications involve the coronary arteries and aorta. There is mild adenopathy in the aortopulmonic window. Increased activity is seen within several of these lymph nodes. The lymph node with the greatest uptake in the AP window has maximum SUV of 5.3 Peripheral to the LEFT upper lobe mass is a vague reticulonodular infiltrate which shows only mildly elevated FDG uptake with SUV of 1.9. This is probably post obstructive infiltrate although lymphangitic spread of tumor is not entirely excluded.

Abdominal images show a few granulomas in the spleen. Otherwise, the liver and spleen are not remarkable. The gallbladder, pancreas, adrenal glands and kidneys are normal. No mass or adenopathy is seen. There is no intestinal distention. There is no focal abnormal FDG uptake in the abdomen or pelvis. No ascites is seen mild degenerative findings are present in the spine.

IMPRESSION: The soft tissue mass at the superior aspect of the LEFT hilum involving the LEFT upper lobe shows abnormal FDG uptake consistent with malignancy. This may represent a primary lung carcinoma. Considering the patient's history of colon carcinoma, metastatic disease is not entirely excluded. Adenopathy in the aortopulmonic window and LEFT hilum also shows increased activity and is most likely metastatic adenopathy. Peripheral LEFT upper lobe infiltrate probably is due to to postobstructive infiltrate although lymphangitic spread of the neoplasm is not entirely excluded. No metastatic disease is identified in the abdomen or pelvis.

CT Scan 5/1/09:
FINDINGS:
The heart size is within normal limits. There is no pericardial effusion or thickening. Coronary arteries calcifications are noted. The thoracic aorta enhances appropriately. Scattered calcifications are noted throughout the aorta.

A 3.4 x 2.5 cm soft tissue mass is seen at the LEFT hilum. It is spiculated and extends into a reticulonodular pattern superiorly and laterally to the pleural margin in the LEFT upper lobe. This is most likely a neoplasm.

A nodular density is seen in the RIGHT upper lobe along the minor fissure. It measures approximately 7 mm this was not demonstrated on prior study. In the posterior aspect of the RIGHT lower lobe there is a pleural based nodule measuring approximately 7 mm, it does not appear significantly changed since 2006. Emphysematous changes are seen bilaterally.There is a small amount of pleural thickening medially at the RIGHT base. No pleural effusion is seen.

Several mildly enlarged lymph nodes measuring up to 14 mm in short axis are present at the AP window. Small calcified lymph nodes are noted in the paratracheal and subcarinal regions. No pathologically enlarged lymph nodes are seen at the RIGHT hilum or axillary regions.

No focal lesion is seen within the visualized structures of the upper abdomen. Tiny calcifications noted in the spleen are likely representing granulomas.

Degenerative change are present in the thoracic spine.

IMPRESSION:
Soft tissue mass at the LEFT hilum extending into the LEFT upper lobe most likely representing a neoplasm.
Mediastinal adenopathy.
Subcentimeter nodules within the RIGHT lung.
Emphysema.

hi, am replying to the lady who asked us to respond to her fathers pet scan.i can only tell you what happened to my dad almost eight years ago.he was a very healthy 77 year old with no medical history.after complaining of shortness of breath it took us almost a full month before we convinced him to go to the doctor.after  a chest x-ray followed immediatly with a cat scan he was dx. with a hilar lung mass,cancer.his doctor knew at once that this mass was inoperable.i can remember verbatum what the oncolgist told us.if he has chemo and radiation he will survive about 18months.without any treatment 6 months.my dad had radiation for five weeks,five days a week.this was followed by almost 6 months of chemo.every 3 weeks.the   oncologist predicted my fathers life expectancy almost to the week.he died just one week short of 18 months.my dad did very well with the treatments.thankfully tolerated them very well but the cancer simply won.i am always grateful for two aspects of his death.first,he never had any pain and second he died at home with his family with him.we all respected his wishes and did as he asked.still miss my dads fantastic jersey tomatoes!like i said that was eight years ago.cancer treatments improve every year so  if infact your dad has cancer his outcome could be better.with that being said pets scans are very accurate dx.tools.wish you and your dad the very best sincerely,stayin alive