A 69-year-old woman was referred for initial staging of an oral cavity mass. 18F-FDG PET/CT displayed a homogeneous intense uptake of the 50-mm left hemipalatal mass with local extension to the dental arcade and maxillary sinus. Infracentimetric bilateral cervical nodes with faint uptake were also detected, contrasting with the usual presentation of other head and neck squamous cell carcinoma. Biopsy concluded to a rare head and neck squamous cell carcinoma subtype: oral cuniculatum carcinoma (OCC). After radiotherapy, 18F-FDG PET/CT showed metabolic complete response. Our case describing specifically the metabolic characteristics of OCC and radiotherapy evaluation for this rare tumor.
ROS-1–positive non–small cell lung cancers (NSCLCs) are rare (approximately 1% of all NSCLCs) and require a first-line treatment by crizotinib. Crizotinib resistance is frequent within the first 12 months of treatment. Lorlatinib is a novel tyrosine kinase inhibitor of ROS-1 recently indicated for metastatic or locally advanced crizotinib-resistant NSCLC. We report the use of lorlatinib as second-line with a complete tumoral response after only 3 months of treatment. This case shows the major role of 18F-FDG PET/CT in treatment evaluation and monitoring targeted therapy in metastatic NSCLC.
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