Initial Results and Clinical Application of Non Dedicated 18-FDG/PET in Head and Neck Oncology

Imaging procedures are important methods for properstage and treatment planning. Especially in previouslytreated patients, although not perfectly accurate. PETscan is a functional and imaging technique that has beenused to diagnose and stage recurrent cancer fromdifferent sites. The combination of computedtomography coupled with FDG-PET (18-FDG-PET/CT)reaches high quality anatomical and functional images.OBJECTIVE: To describe the initial results of FDG-PET/CT performed at a single institution. MATERIAL ANDMETHODS: This technique was used in 63 patients withhead and neck tumors. The purpose of the exam was: a)to rule out recurrent disease - 55 patients; b) to search forhidden primary tumor - 2 patients; and c) postoperativefollow-up of residual disease - 6 patients. Computedtomography (CT) was performed in 56 cases (88.9%).Pathological confirmation was obtained in 24 cases(38.1%), all the remaining cases were considered negativebased on clinical follow-up information with no evidenceof recurrent disease 12 months after the PET/CT exam.RESULTS: Overall results for the accuracy of FDG-PETwere: 93.9% of sensitivity, 64.2% of specificity, 75.6% ofpositive predictive value and 90.0% of negativepredictive value. FDG-PET was able to find 1 out of 2undetected primary tumors (base of the tongue). Thebest results were obtained regarding the detection oflocal and distant recurrences of larynx, thyroid and oralcavity cancers. CONCLUSION: The FDG-PET/CT fusionimage makes anatomical localization easier and theaccuracy for detection of recurrent disease was found tobe higher than CT alone.

Sarcoma granulocítico de mama / Granulocytic sarcoma of breast

Sarcoma granulocítico é uma neoplasia maligna extramedular rara composta de mieloblastos e outros precursores granulocíticos que acomete pacientes leucêmicos. Manifesta-se menos comumente como precursor de leucemia e, nestes casos, o intervalo entre o tumor inicial e o aparecimento de sinais e sintomas de leucemia é de 6 meses em média. Raramente se apresenta como lesäo isolada sem manifestaçäo da leucemia. Relatos anteriores demonstram uma tendência ao tratamento quimioterápico sistêmico igual aquele preconizado para pacientes com leucemia mielóide aguda, mesmo quando ausente, acompanhado de radioterapia local. O presente estudo descreve uma paciente com diagnóstico de sarcoma granulocítico de mama em maio de 1987, com lesäo isolada, sem evidências de leucemia. Foi tratada com ressecçäo segmentar de mama e radioterapia, permanecendo assintomática sem recorrência neste período de 8 anos de acompanhamento.