RESUMO
BACKGROUND: Anal cancer is a rare tumour accounting for â¼2% of all colorectal cancers between 1997 and 2000 in the UK. Staging is still dominated by DRE (digital rectal examination), computed tomography (CT) and magnetic resonance imaging (MRI) imaging. The role of PET as a definitive modality is still emerging and there are relatively few adequate studies in the literature. METHODS: We looked at patients treated radically for anal cancer at Mount Vernon Cancer Centre (UK) between 2009 and 2010. Eighty-eight patients underwent treatment according to data-based coding records of which 46 had positron emission tomography (PET)/CT scans. Notes were unavailable for three patients. We compared staging following conventional modalities (DRE, MRI and CT) and PET/CT scans for these 43 patients. RESULTS: In 18 patients, the PET/CT stage differed from MRI. PET/CT altered the stage in 42% of patients but changes in subsequent management were not implemented. CONCLUSIONS: Our data show that PET/CT does alter staging in a significant number of cases although it did not lead to change in management under the current guidelines. Furthermore, there is agreement that PET/CT shows greater sensitivity for detection of lymph nodes and our study has demonstrated a distinct trend towards upstaging of anal cancer with PET/CT.
Assuntos
Neoplasias do Ânus/diagnóstico por imagem , Neoplasias do Ânus/patologia , Neoplasias do Ânus/terapia , Terapia Combinada , Fluordesoxiglucose F18 , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Metástase Linfática , Imageamento por Ressonância Magnética , Estadiamento de Neoplasias/métodos , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Tomografia Computadorizada por Raios XAssuntos
Erros de Diagnóstico , Hipersensibilidade a Drogas/diagnóstico , Metiltransferases/genética , Substituição de Aminoácidos/genética , Azatioprina/efeitos adversos , Azatioprina/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/genética , Hipersensibilidade a Drogas/enzimologia , Hipersensibilidade a Drogas/genética , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Metiltransferases/deficiência , Erros Inatos do Metabolismo da Purina-PirimidinaRESUMO
We report the case of an 80-year-old man who presented with relapsing prostate cancer and cerebral metastases which showed evidence of radiological and clinical response to androgen suppression alone without additional whole brain radiotherapy.