title: PET evaluation of therapeutic limb perfusion in Merkel's cell carcinoma.
abstract: An 87-yr-old woman diagnosed with recurrent Merkel's cell carcinoma was treated with therapeutic limb perfusion and underwent PET scanning with 18F-fluorodeoxyglucose (FDG). PET studies were obtained before and after treatment to determine the response to the intervention. A baseline whole-body study was obtained to assess the extent and degree of disease activity. This was followed by a repeat PET scan 2 mo. later after treatment with isolated limb chemotherapy with high-dose melphalan and tumor necrosis factor-alpha. The initial scan demonstrated multiple foci of high FDG uptake in the left calf, a left supraclavicular lesion and also detected concurrent keratinizing squamous cell metastasis in the right axilla. A repeat PET study showed complete metabolic resolution of the lesions in the left calf after treatment. FDG PET may be a useful technique for staging Merkel cell carcinoma and for assessing the tumor response after therapy of this rare tumor.
authors.affiliation: Department of Surgery, University of Pennsylvania Medical Center, Philadelphia, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Lampreave
authors.forename: F
authors.initials: F
authors.lastname: Bénard
authors.forename: A
authors.initials: A
authors.lastname: Alavi
authors.forename: J
authors.initials: J
authors.lastname: Jimenez-Hoyuela
authors.forename: D
authors.initials: D
authors.lastname: Fraker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000627:therapeutic use*; D015266:Carcinoma, Merkel Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007866:Leg; D008558:Melphalan / Q000008:administration & dosage / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D012008:Recurrence; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014055:Tomography, Emission-Computed; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D019275:Radiopharmaceuticals; D014409:Tumor Necrosis Factor-alpha; D019788:Fluorodeoxyglucose F18; D008558:Melphalan