Acellular Dermal Matrix Mistaken as Recurrence of Malignancy Following Surgery on Positron Emission Tomography/Computed Tomography: A Case Report

Abstract

Objectives: To report a rare clinical presentation of an acellular dermal matrix (ADM) used during lateral temporal bone resection mimicking recurrence of cancer of external auditory canal (EAC) on positron emission tomography/computed tomography (PET/CT) 9 months after surgery. Methods: Case report and literature review. Results: A 71-year-old woman underwent lateral temporal bone resection 9 months earlier for management of squamous cell carcinoma of the EAC. She exhibited recurrence of the tumor on 18F-FDG PET/CT with an intense uptake value (SUVmax 12.8) at the operated site. Exploration was conducted as the location of the lesion was unfavorable to perform biopsy. However, histopathologic evaluation revealed that the lesion was the ADM implanted during surgery. Conclusions: Care should be taken when using an ADM during malignant tumor surgery if the site of surgery is not conducive for fine needle aspiration or biopsy.

Temporal Bone Resection for Squamous Cell Carcinoma of the Lateral Skull Base: Systematic Review and Meta‐analysis

“…The final list of included articles consisted of 39 case series and 12 case reports ( Table 1 ). 1,9–23,26–60 Based on these criteria, most of the studies were of good quality (mean, 8.7; median, 9) (see Supplemental Table S1 in the online version of the article).…”

“…Patients receiving STBR or TTBR were significantly more likely to have clinical facial nerve palsy at presentation (35.0% vs 7.0%; P \ .001). Patients receiving STBR or TTBR were also more likely to 55 18 2018 Case series Park et al 18 13 2018 Case series Aslıer et al 12 5 2019 Case series Lee et al 56 1 2019 Case report Shinomiya et al 57 25 2019 Case series Seligman et al 22 31 2020 Case series Chen et al 58 2 2020 Case series Xie et al 59 39 2021 Case series Appelbaum et al 60 6 2021 Case series receive adjuvant therapy (ie, chemotherapy, chemoradiation, radiotherapy) when compared to their LTBR counterparts (49.2% vs 46.8%, P = .018). Patients receiving STBR or TTBR were significantly more likely to experience recurrence, as 46.7% of patients experienced recurrence compared to 25.2% of their LTBR counterparts (P \ .001).…”

FDG Localization in Acellular Dermal Matrix, a Potential Cause of Nonpernicious Uptake Following Breast Reconstruction Surgery

“…1 Maximal intensity projection (A), transaxial PET (B), and transaxial CT (C) images demonstrate symmetric, moderately intense bands of FDG uptake outlining the lateral margin of the reconstructed breasts (arrows), corresponding to location of the ADM material, and reflecting cellular incorporation, neovascularization, and ongoing wound repair. Although ADM-related FDG uptake has not previously been described in the context of breast reconstruction, ADM-related uptake has been reported regarding middle-ear reconstruction 2 and hernia repair, exhibiting focal, linear, or nonuniform FDG activity. 3 Specific brands of ADM have a variable time course of incorporation; the ADM used in the current report has rapid incorporation, peaking at 14 days, 4 with well-formed granulomata and cellular incorporation seen at 42 days.…”