Brown Adipose Tissue Mimicking Head and Neck Cancer on PET Scan in a Patient on GLP-1 Drug

Daron B Harrison; Alisa L Phillips; James B Tansey; Travis J Clarke; C B Wood; Lucien Nedzi; David L Schwartz; Liza Makowski; D N Hayes; Grace Newman; John P Gleysteen

doi:10.1002/lary.31815

Brown Adipose Tissue Mimicking Head and Neck Cancer on PET Scan in a Patient on GLP-1 Drug

Laryngoscope. 2024 Oct 7. doi: 10.1002/lary.31815. Online ahead of print.

Authors

Daron B Harrison¹, Alisa L Phillips², James B Tansey¹, Travis J Clarke¹, C B Wood¹, Lucien Nedzi³, David L Schwartz³, Liza Makowski^{4

5}, D N Hayes^{4

5}, Grace Newman⁶, John P Gleysteen¹

Affiliations

¹ Department of Otolaryngology-Head & Neck Surgery, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A.
² Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Tennessee, U.S.A.
³ Department of Radiation Oncology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A.
⁴ Department of Hematology Oncology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A.
⁵ Center for Cancer Research, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A.
⁶ Department of Nuclear Medicine, Methodist Le Bonheur Healthcare, Memphis Radiological PC, Memphis, Tennessee, U.S.A.

PMID: 39370986
DOI: 10.1002/lary.31815

Abstract

To report a case of a patient undergoing GLP-1 receptor agonist therapy in which increased FDG uptake in brown adipose tissue (BAT) mimicked metastatic head and neck cancer on PET/CT imaging. A 61-year-old female with Class III obesity presented with a right-sided neck mass after significant weight loss following the use of the GLP-1 receptor agonist, Semaglutide. PET/CT revealed FDG uptake in the right level II lymph node and extensive BAT uptake throughout the neck and mediastinum, complicating the diagnosis. Increased FDG uptake in the cervical and supraclavicular BAT regions led to diagnostic confusion, mimicking diffuse regional metastasis. Careful interpretation of PET/CT imaging, with fusion of anatomical and functional data, was essential to differentiate hypermetabolic BAT from malignant disease. Increased BAT FDG uptake, particularly in patients using GLP-1 receptor agonists, can complicate the evaluation of head and neck cancer. Awareness of this interaction is critical to avoid misdiagnosis and overtreatment. Laryngoscope, 2024.

Keywords: GLP‐1 drug; PET scan; brown adipose tissue; head and neck cancer.

Publication types

Case Reports

Grants and funding

UG1 CA233333/CA/NCI NIH HHS/United States