Necrotizing fasciitis (NF) is characterized with rapid involvement of soft tissues and fascias and could be fatal if not treated properly. Our patient had history of larynx cancer. He had a tracheostomy and developed NF of the neck and upper mediastinum which is a very rare complication of tracheostomy.

The patient was referred for a Positron Emission Tomography/Computed Tomography (PET/CT) scan after suspicion of residual lesion on follow up computed tomography (CT). On fluorodeoxyglucose (FDG) PET/CT images there was moderate increased uptake at the anterior glottic region, in line with residual disease. PET/CT scan showed progression of the NF involving the neck and upper mediastinum compared to the CT scan performed 10 days before. On PET/CT a new pulmonary abscess was also noted in the lower lobe of the left lung.

In our case FDG PET/CT played an effective role in the follow up of oncologic disorders. It was also useful in the follow up and treatment response of NF, which is a rare but potentially fatal infectious and inflammatory disorder. Positron Emission Tomography/Computed Tomography (PET/CT) could be preferred in the follow up of serious infectious conditions accompanying primary malignancy

Keywords: Necrotizing Fasciitis,18F-FDG, PET / CT , Inflammation