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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anal cancer is an uncommon tumor with an incidence of about one case per 100,000 in most countries. Its incidence seems to be increasing because of exposure to human immunodeficiency virus (HIV) and human papillomavirus (HPV). Traditional pretreatment evaluations include physical examination and CT imaging of the pelvis. Current treatment guidelines include fluorodeoxyglucose positron emission tomography integrated with computed tomography (FDG-PET/CT) as part of the standard pretreatment workup of patients diagnosed with anal cancer. At diagnosis, FDG-PET/CT is used to evaluate primary tumor size, lymph node status and to evaluate for distant metastases. FDG-PET/CT can also be used for radiation therapy treatment planning by clearly defining sites of metabolically active tumor. Posttherapy FDG-PET/CT to determine response to therapy is highly predictive of long-term clinical outcomes. This imaging modality can also be used to evaluate sites of recurrent disease. FDG-PET/CT is an imaging modality which greatly affects the management of patients with anal cancer.
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PMID:FDG-PET/CT: new horizons in anal cancer. 1939 79

Patients with oral squamous cell carcinoma (OSCC) and poor prognosis may benefit from an intensification of the initial therapy scheme. To improve the clinical management of these patients, there is a strong requirement for an accurate assessment of the malignant properties of the individual lesion. The objective of the present analysis was to define the potential value of 2-[(18)F]fluoro-2-deoxy-d-glucose ((18)FDG) uptake in the tumor measured by positron emission tomography (PET) in predicting patients' outcome in the clinical course of OSCC. In this respect, a clinically well-defined cohort of 79 patients with primary OSCC was retrospectively evaluated. (18)FDG uptake in the primary tumor site was quantified by calculation of the maximum standardized uptake values (SUV(max)). Subsequent statistical analyses found, that (18)FDG uptake of the primary tumor was significantly higher in stage T3/T4 vs. T1/T2 (p<0.001), in UICC stage IV vs. stage I-III (p=0.01), and in N1-3 vs. N0 tumors (p<0.001), respectively. To define SUV(max) cut-off values for survival analyses, receiver operating curves (ROC) were calculated for overall and disease-free survival after 36 and 60 months, respectively. Univariate survival analysis showed that high SUV(max) was significantly associated with shortened overall survival after 36 (p=0.026) and 60 months (p=0.02). Subsequent multi-variate Cox regression analysis including SUV(max), age, gender and UICC stage as co-variables determined that, high SUV(max) was the only predictor of inferior overall survival after 60 months (p=0.035) in this model. In conclusion, (18)FDG uptake detected by PET predicts adverse outcome of patients with OSCC in this retrospective analysis. (18)FDG-PET might be a promising tool to contribute to therapeutic decisions and should be evaluated in future prospective studies.
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PMID:High 2-[18F]fluoro-2-deoxy-d-glucose (18FDG) uptake measured by positron emission tomography is associated with reduced overall survival in patients with oral squamous cell carcinoma. 1966 23

A 67-year-old woman who complained of pain and sensory disturbance in the right upper extremity was admitted. Her chest CT showed a mass lesion in the upper lobe of the right lung, indicating invasion to the chest wall. CT-guided tumor biopsy resulted in a diagnosis of squamous cell carcinoma, and FDG-PET scan suggested metastasis to the right supraclavicular lymph node. We diagnosed squamous cell lung cancer (T3N3M0 : stage IIIB) and started chemotherapy using carboplatin and vinorelbine combined with thoracic radiotherapy. At the end of 6th cycles of chemotherapy, exertional dyspnea and palpitations appeared, and she was readmitted. Repeated transthoracic echocardiography showed a deterioration of the thickening of the right ventricular wall. Magnetic resonance imaging and Ga-scintigraphy suggested a neoplastic lesion in the myocardium. Eventually, we diagnosed it as myocardial metastasis from non-small cell lung cancer. Shortly after the beginning of palliative radiotherapy to the myocardial lesion, repeated episodes of ventricular tachycardia emerged. We stopped radiotherapy and managed to control the ventricular tachycardia by initiating amiodarone. Though we administered erlotinib as a second line chemotherapy, the primary tumor and pericardial effusion progressed and pleural effusion appeared, so we discontinued erlotinib. Pericardiocentesis was carried out to improve her symptoms and cytological examination of effusion revealed class IV. Her performance status dropped off and we decided to continue best supportive care. Myocardial metastasis of lung cancer is rarely a clinical problem, but it might have a decisive influence on the patient's prognosis due to serious arrhythmia or some other complications. Therefore, there is a need to consider cardiac involvement in the course of lung cancer.
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PMID:[Case of squamous cell lung cancer with myocardial metastasis complicated with ventricular tachycardia]. 1982 87

Carcinoma of unknown primary (CUP) is a heterogeneous group of metastatic malignancies in which a primary tumor could not be detected despite thorough diagnostic evaluation. Because of its high sensitivity for the detection of lesions, combined (18)F-fluoro-2-deoxyglucose positron emission tomography (FDG PET)/computed tomography (CT) may be an excellent alternative to CT alone and conventional magnetic resonance imaging in detecting the unknown primary tumor. This article will review the use, diagnostic performance, and utility of FDG PET/CT in CUP and will discuss challenges and future considerations in the diagnostic management of CUP.
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PMID:FDG PET/CT in carcinoma of unknown primary. 1988 52

The hybrid technique of PET/CT has significantly impacted the imaging and management of HNSCC since its introduction in 2001 and has become the technique of choice for imaging of this cancer. Diagnostic FDG-PET/CT is useful for identification of an unknown primary tumor, delineation of extent of primary tumor, detection of regional lymph node involvement even in a normal-sized node, detection of distant metastases and occasional synchronous primary tumor, assessment of therapy response, and long-term surveillance for recurrence and metastases. The role of PET/CT is evolving in radiation therapy planning. Combined diagnostic PET/CT provides the best anatomic and metabolic in vivo information for the comprehensive management of HNSCC.
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PMID:Fluorodeoxyglucose-positron-emission tomography imaging of head and neck squamous cell cancer. 1991 Apr 48

We report a case of 58-year-old woman referred to our service for an (18)FFDG PET/CT study of initial staging after being diagnosed of a pelvic kidney mass consistent with malignancy. The FDG-PET showed an abnormal mass in the right kidney, a suspicious metastasis versus a second primary tumor in the cortex of the kidney and lymph node infiltration in the paracaval nodes. The histological analysis verification after exeresis of the lesions confirmed the diagnosis of renal metastases. In this article, we present a brief review of the literature published on the role of PET in the characterization and initial staging of kidney and urinary tract tumors. We also stress the clinical importance of carefully evaluating any low attenuation lesion or focal glucose uptake detected in these structures in a PET/CT study with (18)FFDG.
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PMID:[PET/CT with (18F)FDG in the initial staging of a pelvic kidney neoplasm. A case report]. 1992 33

Fluorine-18 fluorodeoxyglycose -position emission tomography ((18)F-FDG-PET) as an efficient staging tool for lung carcinoma; allows description and characterization of the primary tumor and of local and distant metastases in a single examination. One of the important limiting factors in quantification of metabolic parameters with PET is the partial volume effect. Our aim for this study was to delineate tumor (size) both in the primary and metastatic lesions in patients with lung cancer by using partial volume correction techniques. Thirty two patients with proven lung cancer who had (18)F-FDG-PET and computerized tomography (CT) within the last 80 days were involved in this study. They were 18 women and 14 men, with age range 43-83 years. Maximum standardized uptake values (SUVmax) in primary and metastatic lesions for all patients were measured. The lesions were categorized into 4 different Groups according to their site. Partial volume corrections were applied using the CT sizes of lesions to obtain corrected SUVmax values. Average corrected SUVmax in each lesion site was calculated and compared between the 4 Groups. A total of 81 primary and metastatic lesions were included in this analysis. They were 28 mediastinal-hilar lymph node lesions, 26 lung lesions, 11 solid organ lesions, and 16 bone marrow lesions. The average uncorrected SUVmax for the primary lung lesions, mediastinal-hilar lymph node lesions, solid organ lesions, and the bone marrow lesions before application of partial volume correction formula were 7.2+/-3.2; 7.0+/-2.7; 6.3+/-3.4 and 7.0+/-3.4, respectively. The average corrected SUVmax for the lesions in the above mentioned regions were 11+/-6, 10+/-4, 13+/-7, and 18+/-13, respectively. A statistically significant difference was observed in the average SUVmax values between lung lesions and nodal lesions compared to the bone marrow lesions. In conclusion, our findings indicate that metabolic activities of lung cancer lesions vary depending on the sites of metastatic disease.
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PMID:Tumor metabolism measured by partial volume corrected standardized uptake value varies considerably in primary and metastatic sites in patients with lung cancer. A new observation. 1993 31

A 39 years old male patient with a history of an unresectable thymoma and synchronous liver metastases was referred tor our position. The patient had been originally treated with systemic chemotherapy followed by imatinib (Glivec) and sunitinib (Sutent). Since the therapeutic response was unsatisfactory, a gallium-68 ((68)Ga)-Dotatoc-positron emission tomography (PET) was performed and demonstrated an enhanced SSTR 2 expression in the primary tumor but not in the liver metastases. Three cycles of yttrium-90 ((90)Y)-Dotatoc were then administered. Outcome after treatment was monitored by (18)F-FDG-PET and CT and showed a response only of the primary tumor. Selective internal radiation treatment (SIRT) with (90)Y microspheres was then applied for the liver metastases. (18)F-FDG uptake showed that metabolism in the liver metastases decreased after SIRT. MRI of the liver demonstrated a decrease in vascularization and a modest decrease in tumor volume. Therefore, surgical resection of the primary thymoma was initiated.
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PMID:Treatment monitoring with 18F-FDG PET in metastatic thymoma after 90Y-Dotatoc and selective internal radiation treatment (SIRT). 1993 42

18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a nuclear medicine imaging technique which has been increasingly applied as a diagnostic tool. The usefulness of FDG-PET may be described as follows: I . Early detection of cancer; II. Diagnosis of cancer; III. Detection of nodal or distant metastasis, and double cancer; IV. Detection of unknown primary tumor with metastatic neck lesions; and V. Evaluation of treatment of head and neck cancer. FDG-PET is especially useful to detect distant metastasis, double cancer with head and neck cancer and unknown primary tumor with metastatic neck lymph nodes. The conventional modalities, e. g., CT or MRI, show anatomical images in the body. On the other hand, FDG-PET reveals three-dimensional images of functional processes of the glucose metabolism. FDG-PET can estimate metabolic activity in cancer and is useful in evaluating or monitoring the response to concurrent chemoradiotherapy of the head and neck cancer. However, we should recognize the limitations of FDG -PET. An acute inflammatory disease shows high FDG uptake like cancer. It is difficult to detect early-stage esophageal cancer or to diagnose parotid gland cancer.
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PMID:[The role and limitations of FDG-PET in head and neck cancer]. 2000 54

We describe here two cases of locally advanced rectal cancer treated with neoadjuvant chemotherapy prior to surgery. The first patient was a 54-year-old man whose chief complaint was bloody stool. A detailed examination revealed a rectal cancer with direct invasion of the primary rectal carcinoma into the prostate. Four courses of FOLFOX4 were administered as neoadjuvant chemotherapy. Because the invasion to the prostate was difficult to determine by subsequent CT evaluation, we performed a radical resection. The pathological examination revealed that all surgical margins were negative for malignancy and no metastasis to lymph nodes was found, therefore a surgical evaluation of curability was classified as A. The second patient was a 49-year-old woman whose chief complaint was irregular menstruation. A detailed examination revealed a rectal cancer with metastasis to an ovary and paraaortic lymph node. One course of FOLFOX4 and six courses of mFOLFOX6 (combined with bevacizumab in the first five courses) were administered as neoadjuvant chemotherapy. Subsequent examinations revealed significantly reduced primary tumor and the size of metastatic lesion. Given that metastasis to the paraaortic lymph node was difficult to determine, we performed a radical resection. The pathological examination revealed that all surgical margins were negative for malignancy, and the postoperative FDG-PET evaluation did not find FDG accumulation to paraaortic lymph node. We determined that there was no residual cancer and evaluated the surgery as curability B. We conclude that neoadjuvant chemotherapy against locally advanced rectal cancer may improve the curability of the surgery and save the surrounding organs.
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PMID:[Two cases of advanced rectal cancer resected successfully after neoadjuvant chemotherapy with FOLFOX regimen]. 2003 27


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