The added value of<sup>18</sup>F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy

Prowse, Simon; Shaw, Richard; Ganeshan, Dhakshina Moorthy; Prowse, Phoebe; Hanlon, Rebecca; Lewis-Jones, Huw; Wieshmann, Hülya

doi:10.1017/s002221511300162x

Cited by 11 publications

(5 citation statements)

References 27 publications

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“…Therefore, the diagnosis is very significant. A diagnosis includes a thorough patient history, gender, clinical examination, a basic lab draw with the most relevant tumor markers, and contrast-enhanced chest/abdominal/pelvic CT. PET/CT may be warranted in some situations, especially when considering local or regional therapy or in the cervical lymph nodes suggestive of head and neck cancer ( 9 , 10 ). IHC analysis plays an important role in the diagnostic work-up in CUP, characterization of the tumor type.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

et al. 2022

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BackgroundCancer of unknown primary (CUP) is heterogeneous and has a wide variety of clinical presentations and a poor prognosis in most patients, with a median overall survival of only 6 months. The development of molecular profiling contributes to precision therapy, and targeted drugs and immune checkpoint inhibitors (ICIs) greatly promote individualized treatment.Case presentationHere, we reported a case of an unfavorable subset of CUP who had a long time of survival after the immunotherapy-prominent comprehensive treatment. A 48-year-old man presented with back pain and a cough. A diagnostic work-up showed bone marrow, multiple bones, and lymph node metastasis. Lymph node pathology implies metastatic poorly differentiated cancer. Next-generation sequencing (NGS) showed no special targets, but the tumor proportion score (TPS) of programmed death-ligand 1 (PD-L1) was 80% and the tumor mutation burden (TMB) was 16.7 per million bases. After two cycles of pembrolizumab 200 mg D1 plus nanoparticle albumin-bound (nab)-paclitaxel 200 mg D1&8 (q3w), PET-CT and bone marrow aspiration cytology showed a complete response (CR). Subsequently, pembrolizumab alone was used for three months. The left inguinal lymph nodes showed new metastasis. After two cycles of the combination treatment of pembrolizumab and (nab)-paclitaxel, a partial response (PR) was achieved. After seven months, retroperitoneal lymph nodes showed new metastasis, and the sequential treatment with radiotherapy and pembrolizumab exhibited encouraging efficacy. To date, the patient has survived nearly 40 months with the combination therapy.ConclusionsThe ICI-prominent comprehensive treatment provided clinical benefit for the reported case of CUP. Thus, CUP patients with markers of benefiting from immunotherapy should be actively treated with immunotherapy to improve their prognosis.

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Section: Discussionmentioning

confidence: 99%

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

et al. 2022

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“…By identifying areas of augmented glucose uptake, PET can localize malignancies, metastatic lesions, and unknown primary tumors [1]. While PET-CT has a negative predictive value up to 100% [2] there is a multuplicity of conditions that physiologically increase SUV.…”

Section: Discussionmentioning

confidence: 99%

Metachronous Malingnancy, 27 Years After Teflon Cordal Injection

Bottazzoli¹,

Marcantoni²,

Picori³

et al. 2019

Arch Clin Med Case Rep

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We report a rare case of a patient known for a long-time history of iatrogenic VC paralysis, with unusual PET-CT findings. Due to a bilateral paragangliomas (PGLs), 27 years before the patient underwent a left jugulopetrosectomy. After admission for contralateral sudden hearing loss, MRI and PET-CT scans were acquired. We tried to critically analyze the clinical relevance of multimodal imaging in an unusual condition of comorbities.Moreover, we suggested a physiopathological interpretation of collecting imagings and clinical otorhinolaryngological aspects. We could determine that high SUV in paralyzed left VC was related to a foreignbody reaction after laryngeal injection by polytetrafluoroethylene fluoropolymer resin (Teflon) performed 27 years before. Moreover, an asymptomatic pT1c mixed lung adenocarcinoma was serendipitously detected in the left lung.The SUVs of these two lesions were both compatible with neoplasms. A further possible lesion in the right lung highlighted by MRI was not confirmed by PET-CT imaging (MRI artifact). Although Teflon is no longer in use for laryngeal injection, clinicians should be aware of the potential misinterpretation laryngeal findings in patients with such a clinical history, even long time after the procedure.

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“…Prowse et al [49] retrospectively studied 32 such patients with PET/CT. PET/CT found 50 % of the unknown primaries, with a sensitivity of 94 % and specificity of 67 %.…”

Section: Dce Perfusion Mrimentioning

confidence: 99%

Lymph Node Disease and Advanced Head and Neck Imaging: A Review of the 2013 Literature

Khan

2014

Curr Radiol Rep

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Detection and differentiation of lymph node disease in the head and neck can be very difficult but is of importance for staging and treating head and neck (H&N) tumors. This topic is therefore a source of much ongoing study. With constantly evolving imaging technology, there is an ongoing need for evaluation of both new and improved techniques, and potential new uses of current modalities. CT, MRI, and PET are examined in this article, with a focus on H&N disease processes and the technical aspects of imaging. The goal of this review article is to bring the reader up to date on pertinent articles in advanced imaging of H&N lymph node disease from the year 2013.

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The added value of¹⁸F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy

Abstract: Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

Cited by 11 publications

References 27 publications

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

Metachronous Malingnancy, 27 Years After Teflon Cordal Injection

Lymph Node Disease and Advanced Head and Neck Imaging: A Review of the 2013 Literature

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The added value of18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy

Abstract: Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

Cited by 11 publications

References 27 publications

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

Case Report: Successful Immunotherapy Improved the Prognosis of the Unfavorable Subset of Cancer of Unknown Primary

Metachronous Malingnancy, 27 Years After Teflon Cordal Injection

Lymph Node Disease and Advanced Head and Neck Imaging: A Review of the 2013 Literature

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The added value of¹⁸F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy