Artikel
18F-FDG-PET in ENT-oncology for patients presenting with a carcinoma of unkonwon primary (CUP)
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Autoren
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Matthias Scheich
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke der Universität Würzburg
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Stefan Hilliger
- Klinik und Poliklinik für Nuklearmedizin der Universität Würzburg
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Florian Hoppe
- Klinik für HNO-Krankheiten der Klinikum Oldenburg gGmbH, ldenburg
| Veröffentlicht: | 22. September 2005 |
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Gliederung
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Introduction: The prognostic outcome of patients suffering from cervical lymph node metastases of an unknown primary is poorer compared to those patients in which the primary tumor can be found.
Positron emission tomography (PET) is often used as a supportive tool for detection of primary tumors.
Methods: From June 2001 to March 2005 we used PET in 83 patients. In most cases (60/83) it was used to detect an unknown primary tumor in patients where lymph node metastases were suspected by cytological or histopathological means. PET-imaging was done in addition to CT or MR-scans before panendoscopy (including tonsillectomy).
Results: In 9 cases histopathological examinations denied the presence of malignant metastases. In 21 of the remaining 51 CUP-patients PET described a suspicious primary tumor. Malignancy could be proven histological in 10 cases. In 3 of these 10 „true positive“ cases, positron emission tomography was the deciding tool to detect of the primary tumor.
Standardised panendoscopy showed a primary tumor in 15 of the 51 cases. We found 6 tonsil carcinomas which where not detected by PET, even if 2 were bigger than 2 cm (T2).
Nevertheless in 30/51 patients, the primary tumor was never found.
Conclusion: Positron emission tomography completes the search for an unknown primary tumor in patients with cervical metastases of an unknown primary cancer.
All diagnostic tools should be used to improve survival.
It was shown that panendoscopy in patients with cervical CUP-syndrome requires tonsillectomy.
