Three patients presented with distant (lymph node metastases n = 3 (affection of paraaortal and mediastinal lymph node metastases), peritoneal metastases n = 2, bone metastases n = 1), FAP positive metastases at the preoperative FAPI scan (all [68Ga]Ga-FAPI- 46 scans). Here, FAP is linked to metastatic malignant neoplasm in the lymph nodes.