Teflon granuloma results in a false-positive "second primary" on 18F-2-deoxyglucose positron emission tomography in a patient with a history of nasopharyngeal cancer.

18F-2-deoxyglucose positron emission tomography (PET) is a frequent diagnostic tool used to evaluate patients with head and neck squamous cell carcinoma (HNSCC). 18F-2-deoxyglucose-PET is used in this setting for detection of metastases (staging) and/or second primaries. False-positive PET scans (10%-15% frequency) can distract from accurate HNSCC staging and an orderly prescription for treatment. Teflon (DuPont, Wilmington, DE) vocal fold injections can result in granuloma formation that has been described to generate a false-positive uptake on PET. We present a case of an injected vocal cord that appeared as a second laryngeal primary in a patient with recurrent nasopharyngeal cancer.