Work

FDG PET-CT missed tibial metastasis in head and neck cancer, case report and systematic review

Year: 2024

Type: review

Abstract: INTRODUCTION: Head and neck squamous cell carcinoma (HNSCC) is the seventh most common type of cancer in the world. Metastases occur in up to 40 % of cases and bones are the second most frequent site. Metastases in extremities are uncommon with very few publications covering distal lower-limb bone metastasis. CASE PRESENTATION: Here we report the case of a patient with HNSCC managed by induction chemotherapy, surgery and adjuvant chemo-radiotherapy. During the adjuvant treatment, the patient presented pain in the right tibia, with additional workup revealing a distal lower-limb bone metastasis which had remained undetected during the recommended standard workup for HNSCC. DISCUSSION: Current guidelines request that FDG PET-CT is performed down to the popliteal fossae. The undetected metastasis led to overtreatment of the patient. Systematic review of the literature showed only six cases of head and neck cancer's distal lower-limb metastasis which are eligible for discussion. CONCLUSION: Although rare, physicians should keep in mind that as recommended FDG PET-CT does not extend below the popliteal fossae, metastases could be missed and therefore lead to inappropriate treatment.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2024.110677

Authors: Vanden Haute Noémie, Vervaet Catherine, Maindiaux Laure, Taylor Stephen, Durieux Valerie, Holbrechts Stephane

Institution: Université Libre de Bruxelles

Language: English

Topic: Medical Imaging Techniques and Applications

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,800