Unusual Initial Presentation of Epileptic Seizures in a Pediatric Patient With Neuroblastoma Detected by 18F-FDG PET/CT Imaging

A 5-year-old boy presented with epileptic seizures persisting for ~3 months. To localize the epileptogenic focus, 18 F-FDG PET/CT imaging was performed. Brain PET/CT revealed increased 18 F-FDG uptake in the right frontal lobe, which was consistent with the clinical manifestations observed during the seizure phase. The torso PET/CT identified a mass in the right adrenal region exhibiting moderate 18 F-FDG uptake. Histopathologic examination of the right adrenalectomy specimen confirmed the diagnosis of neuroblastoma. The patient remained seizure-free 2 weeks after surgery. In this case, epileptic seizures represent an unusual and rare initial presentation of neuroblastoma, which was incidentally detected by 18 F-FDG PET/CT.