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    Squamous cell carcinoma arising from a Zenker's diverticulum: contribution of FDG-PET/CT to the diagnosis
    (Wiley-Blackwell, 2016) Acar, Türker; Savas, Recep; Kocaçelebi, Kenan; Ersöz, G.
    A 69-year-old man was admitted to the gastroenterology department with bloody vomiting and syncope.He had a history of hepatitis B (with the following serologic markers: HBsAg, negative; HBeAg, negative; anti-HBc IgM, negative; anti-HBc, positive; antiHBs, 173.21 mIU/mL; anti-HCV, negative), alcohol consumption, and chronic liver disease. He had severe anemia with hemoglobin of 8 g/dL (reference value 11.7–15.5 g/dL) at presentation. The Child–Pugh, Model for End-Stage Liver Disease (MELD), and Rockall scores were 6, 11, and 5, respectively, at the time of bleeding. Upper gastrointestinal system endoscopy performed after stabilizing his vital signs revealed esophageal varices with no active bleeding, which were treated with band ligation and a Zenker’s diverticulum (ZD). Reevaluation endoscopy showed regression of the esophageal varices and a barium swallow study following the reevaluation endoscopy showed the extent of the ZD (Fig. 1). At follow-up, right posterior cervical lymphadenopathy (LAP) was detected and follow-up endoscopy revealed a 0.5 cm polypoid mass on the wall of the ZD (Fig. 2). The pathology of the esophageal mass and LAP were consistent with squamous cell carcinoma (SCC) and SCC metastasis, respectively. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for staging confirmed an FDG-avid mass lesion arising from the ZD (Fig. 3). The patient was initially managed with radiotherapy, and the mass lesion in the ZD regressed completely (Fig. 4). After radiotherapy the patient had complaint of dysphagia