ABSTRACT
PURPOSE: To evaluate the effectiveness of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the identification of early stage (T1-T2) primary and recurrent laryngeal cancer. MATERIALS AND METHODS: Twelve patients with T1 or T2 laryngeal cancer underwent imaging prospectively with PET. Seven patients had new disease, and five had recurrent disease. All patients underwent imaging prior to planned therapy and tissue biopsy. PET images were evaluated by using standardized uptake ratios and visual analysis. RESULTS: Histopathologic evidence of early stage cancer was documented in the 12 patients. One had a carcinoma in situ, nine had T1 tumors, and two had T2 tumors. Of the 12 patients, 10 had vocal cord tumors, one had a hypopharyngeal tumor, and one had a preepiglottic tumor. Eleven (92%) patients with early stage cancer had standardized uptake ratios indicative of malignancy (mean, 4.6; SD, 1.8; 95% CI, 1.2; range, 2.8-7.6). One had false-negative results (standardized uptake ratio = 2.3). Nine underwent CT, and results in the larynx were normal in seven and abnormal in two. CONCLUSION: FDG PET can be used to identify primary and recurrent early stage laryngeal cancer. It may be useful for follow-up after therapy.
Subject(s)
Carcinoma in Situ/diagnostic imaging , Fluorodeoxyglucose F18 , Laryngeal Neoplasms/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Tomography, Emission-Computed , Carcinoma in Situ/pathology , Carcinoma in Situ/radiotherapy , Follow-Up Studies , Humans , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/radiotherapy , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/radiotherapy , Neoplasm Staging , Prospective Studies , Tomography, X-Ray Computed , Vocal Cords/diagnostic imaging , Vocal Cords/pathologyABSTRACT
Hair relaxer, a commercially available alkaline product, is commonly the offending agent in caustic ingestion. These patients often experience oral cavity and facial burns; however, no clinically significant esophageal injuries have been reported. Therefore, we questioned the therapeutic and economic efficacy of the "standard treatment protocol" that includes hospitalization and endoscopic evaluation. Twenty-six patients over a 7-year period presented to our institution having ingested hair relaxer. Presenting signs and symptoms, esophageal findings, and cost of the standard treatment protocol were reviewed. Also, we analyzed the caustic potential and current packaging of hair relaxer. Our findings support modifications in the standard treatment protocol for hair relaxer ingestion including elimination of hospitalization and endoscopy in most patients. We also question compliance with childproof packaging laws and suggest avenues for prevention of hair relaxer ingestion.
Subject(s)
Burns, Chemical/etiology , Caustics/adverse effects , Deglutition , Esophagoscopy , Hair Preparations/adverse effects , Burns, Chemical/diagnosis , Calcium Hydroxide/adverse effects , Clinical Protocols , Cost-Benefit Analysis , Esophagus/injuries , Facial Injuries/etiology , Female , Follow-Up Studies , Guanidines/adverse effects , Hospitalization , Humans , Hydrogen-Ion Concentration , Infant , Lip/injuries , Male , Mouth/injuries , Pharynx/injuries , Product Packaging , Retrospective StudiesABSTRACT
Third branchial arch anomalies are rare. The authors present a case report of a neonate with a rapidly growing neck mass due to cystic dilation of a persistent thymopharyngeal duct, which is a derivative of the third branchial arch. The presence of thyroid and thymic tissue in the cyst wall, the communication of the cyst with the piriform sinus, and the relationship of the cyst to carotid vessels and the sternomastoid muscle were consistent with the features of a thymopharyngeal duct cyst embedded in the thyroid gland.
