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. 2012 Jun 18:4:34.
doi: 10.1186/1758-3284-4-34.

Positron emission tomography in the detection of occult primary head and neck carcinoma: a retrospective study

Gabriel Pereira  1 , Joaquim Castro Silva, Eurico Monteiro
Affiliations

Positron emission tomography in the detection of occult primary head and neck carcinoma: a retrospective study

Gabriel Pereira et al. Head Neck Oncol. .

Expression of concern in

  • Comment: Head and Neck Oncology.
    BioMed Central. BioMed Central. BMC Med. 2014 Feb 5;12:24. doi: 10.1186/1741-7015-12-24. BMC Med. 2014. PMID: 24499430 Free PMC article. Review.

Abstract

Background: The management of cervical lymph node metastases from an unknown primary tumor remains a controversial subject. Recently, Positron Emission Tomography (PET) has proved useful in the detection of these tumors, even after an unsuccessful conventional diagnostic workup. This study was performed to assess the role of PET in the detection of occult primary head and neck carcinomas.

Methods: A retrospective analysis of a four year period at a tertiary referral oncology hospital was conducted.

Results: Of the 49 patients with cervical metastases of carcinoma from an unknown primary, PET detected a primary in 9 patients and gave 5 false positive and 4 false negative results. Detection rate, sensitivity, specificity and accuracy were of 18.4%, 69.2%, 86.1% and 81.6%, respectively. PET was also of substantial benefit in detecting distant metastatic disease and, thus, altered therapeutic strategies in a significant amount of patients.

Conclusions: Therefore, PET is a valuable tool in the management of patients with occult primary head and neck carcinoma, not only because it provides additional information as to the location of primary tumors, but also due to the fact that it can detect unexpected distant metastases.

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Figures

Figure 1
Figure 1
Case example of a false positive FDG-PET finding. Axial, sagittal and coronal views of the PET scan are displayed and demonstrate an uptake in the supraglottic region. The area was free of tumor when examined through careful panendoscopy and multiple deep directed biopsies were negative for neoplasia.
Figure 2
Figure 2
Management flow chart for unknown primary head and neck carcinoma.
See this image and copyright information in PMC

References

    1. Rusthoven KE, Koshy M, Paulino AC. The role of fluorodeoxyglucose positron emission tomography in cervical lymph node metastases from an unknown primary tumor. Cancer. 2004;101:2641–2649. doi: 10.1002/cncr.20687. - DOI - PubMed
    1. Mahoney EJ, Spiegel JH. Evaluation and management of malignant cervical lymphadenopathy with an unknown primary tumor. Otolaryngol Clin N Am. 2005;38:87–97. doi: 10.1016/j.otc.2004.10.014. - DOI - PubMed
    1. Di Martino E, Nowak B, Hassan HA, Hausmann R, Adam G, Buell U, Westhofen M. Diagnosis and staging of head and neck cancer: a comparison of modern imaging modalities (positron emission tomography, computed tomography, color-coded duplex sonography) with panendoscopic and histopathologic findings. Arch Otolaryngol Head Neck Surg. 2000;126:1457–1461. doi: 10.1001/archotol.126.12.1457. - DOI - PubMed
    1. Greven KM, Williams DW, McGuirt WF, Harkness BA, D’Agostino RB, Keyes JW, Watson NE. Serial positron emission tomography scans following radiation therapy of patients with head and neck cancer. Head Neck. 2001;23:942–946. doi: 10.1002/hed.1136. - DOI - PubMed
    1. Jungehulsing M, Scheidhauer K, Damm H, Pietrzyk U, Eckel H, Schicha H, Stennert E. 2[F]-Fluoro-2-deoxy-D-glucose positron emission tomography is a sensitive tool for the detection of occult primary cancer (carcinoma of unknown primary syndrome) with head and neck lymph node manifestation. Otolaryngol Head Neck Surg. 2000;123:294–301. doi: 10.1067/mhn.2000.104807. - DOI - PubMed

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