Pancreatic adenosquamous carcinoma (PASC) represents a rare, aggressive exocrine neoplasm. We describe a 33-year-old woman with an aggressive disease trajectory and limited survival. Baseline 18 FFDG PET/CT enabled accurate staging and treatment planning of stage IV malignancy. Following FOLFIRINOX chemotherapy, complete metabolic resolution was achieved on follow-up 18 FFDG PET/CT. Nevertheless, disease relapse ensued within 5 months. During restaging, 18 FFDG PET/CT failed to reveal any hypermetabolic lesions, whereas 68 GaGa-FAPI PET/CT successfully identified both local and metastatic recurrences. Notably, this case highlights the superiority of 68 GaGa-FAPI PET/CT for detecting recurrent PASC compared with 18 FFDG PET/CT.
Abdlkadir et al. (2026) studied this question.