Primeri bilinmeyen boyun metastazında pozitron emisyon tomografisi ile primer kanserin saptanması: Olgu sunumu

Boyunda kitle şikayetiyle başvuran hastaların %1- 3’ünde primer odağı bilinmeyen boyun metastazlı kanserler bulunmaktadır. Primer odak çoğu kez en- doskopi, bilgisayarlı tomografi, manyetik rezonans görüntüleme gibi tanısal incelemeler ile saptanama- makta, bu da hastaların tedavisini ve prognozunu olumsuz yönde etkilemektedir. Kırk üç yaşında bir erkek hasta boynunda ağrısız şişlik şikayetiyle başvurdu. Hastanın bir dış merkezde daha önceden ya- pılan boyun biyopsisi metastatik karsinom olarak bildirilmişti. Boyundaki kitlenin pirimer odağı pek çok tanı yöntemi ile araştırılmış ancak saptanamamıştı. Hastanemizde yapılan floro-deoksi-glukoz ile pozit- ron emisyon tomografisi dil kökünün primer odak olabileceği gösterdi. Yapılan dil kökü biyopsisi bu tanıyı doğruladı. Bu görüntüleme tekniğinin, primeri bilinmeyen boyun metastazlı baş-boyun kanserli olgu- larda kullanılabileceği akılda tutulmalıdır

Detection of primary carcinoma by positron emission tomography in an unknown primary tumor with cervical metastasis: a case report

Unknown primary tumors with cervical metastasis account for about 1 -3% of patients with neck masses.İn many cases, the primary site cannot be detected by diagnostic procedures such as endoscopy, computed tomography, or magnetic resonance imaging, affecting the treatment and prognosis of these patients unfavor- ably. A 43-year-old male patient presented with a painless mass in the neck. He had previously undergone a neck biopsy, the result of which had been reported as metastatic carcinoma. The primary site could not be determined by extensive diagnostic procedures.Investigation with positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose suggested the base of the tongue as the primary site, which was then con- firmed by an endoscopic biopsy from the tongue. İt should be borne in mind that positron emission tomog­ raphy may be helpful in the diagnosis of unknown pri­ mary tumors with cervical metastasis.

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