Vol 20, No 5 (2015)
Original reearch articles
Published online: 2015-09-01

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Carcinoma of unknown primary in the head and neck: The evaluation of the effectiveness of F-FDG-PET/CT, own experience

Ewa Majchrzak1, Witold Cholewiński2, Wojciech Golusiński1
DOI: 10.1016/j.rpor.2015.07.002
Rep Pract Oncol Radiother 2015;20(5):393-397.

Abstract

Aim

The aim of the present study was to estimate the clinical effectiveness of 18F-FDG-PET/CT in the detection of the primary tumor in patients with histologically proven squamous cell carcinoma cervical lymph nodes metastasis from an unknown primary.

Background

18F-fluorodeoxyglucose positron emission tomography combined with CT (18F-FDG-PET/CT) is believed to be very helpful in localization of primary tumor in CUP Syndrome patients.

Material and method

41 patients referred to Poznan Medical University Department of Head and Neck Surgery from January 2010 to December 2013 with CUP Syndrome were included in the study. All patients presented fine-needle biopsy proven squamous cell carcinoma metastasis of the upper-, or mid neck lymph nodes. The final results were obtained from the histopathologic reports of tissue samples from anatomical regions suspected for primary tumor, additional imaging exams as well as clinical follow-up data.

Results

The 18F-FDG-PET/CT successfully detected primary tumor in 7 out of 41 patients (17%). In two more cases the primary tumor was indicated in the lung. 24 of 41 patients (58.5%) analyzed in our study remained without evidence of a primary tumor. In 4 cases (9.75%) we did not reveal any pathology within the localizations indicated by PET/CT on panendoscopy. In 4 cases we obtained histological confirmation of neoplasm on panendoscopy despite the negative results of PET/CT examinations.

Conclusion

We may suppose a relatively high usefulness of 18F-FDG-PET/CT in the diagnosis process of CUP Syndrome patients. High NPV may indicate patients with no symptoms of primary tumor, which allows to avoid extensive resection or extra imaging.

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