This article reports a case of rare pulmonary metastases arising from an ovarian granulosa cell tumor using 18F-NOTA-FAPI-04 PET/CT. We discussed a patient who was diagnosed with ovarian granulosa cell tumor (stage IA) after surgery 15 years ago and developed pulmonary metastases. The metastatic lesions with solid and (or) cystic components displayed variable (none to mild) fluorodeoxyglucose (FDG) avidity and significantly higher uptake of FAPI. This case highlighted the utility of 18F-NOTA-FAPI-04 PET/CT, suggesting that it may serve as a promising novel tool for the diagnosis and staging of ovarian granulosa cell tumors.
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