An Extraordinary Case of Brown Fat Distribution.

We report the case of a 27-year-old woman who underwent an F-18-FDG PET/CT, after administration of 20 mg propranolol, 20 minutes preinjection, to investigate B-symptoms as well as right-sided shoulder pain. Unilateral hypermetabolism was seen in the left cervical, thoracic, and paravertebral brown fat, without any uptake on the contralateral side. The patient was born with neuroblastoma in the right thoracic area. She underwent surgery a few days after birth. As brown fat activation is under sympathetic control, we hypothesize that a surgical lesion to the right orthosympathetic trunk resulted in sympathetic denervation, responsible for this distribution.