title: Lymph node metastasis of squamous cell carcinoma from an unknown primary in the upper and middle neck: Impact of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.
abstract: OBJECTIVE
  The purpose of this study was to assess the potential of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging for detection of the primary tumor and its impact on treatment planning in patients presenting with cancer of unknown primary and squamous cell carcinoma (SCC)-positive cervical lymph nodes of the upper and middle neck.
  
  
  METHODS
  The study population consisted of 18 consecutive patients with biopsy-proven SCC involving lymph nodes of the upper and middle neck region and negative conventional diagnostic procedures with regard to the location of the primary. All patients underwent FDG-PET/CT according to a standard procedure in search for the primary, unidentified tumor.
  
  
  RESULTS
  In none of the patients FDG-PET/CT was able to indicate a primary tumor localization. Although FDG-PET/CT did identify all sites of known lymph node involvement, neither additional sites of lymph node involvement nor sites of distant metastases were identified. Accordingly, FDG-PET/CT did not impact patient treatment planning.
  
  
  CONCLUSIONS
  In this series, including patients suffering from lymph node metastases by an SCC of unknown primary in the upper and middle neck, FDG-PET/CT was unable to identify a primary tumor. In addition, FDG-PET/CT did not modify the treatment planning in any of the patients studied.
authors.affiliation: Department of Head and Neck Surgery, University Hospital Ghent, Belgium. philippe.deron@ugent.be
authors.forename: Philippe B
authors.initials: PB
authors.lastname: Deron
authors.forename: Katrien M
authors.initials: KM
authors.lastname: Bonte
authors.forename: Hubert F
authors.initials: HF
authors.lastname: Vermeersch
authors.forename: Christophe
authors.initials: C
authors.lastname: Van de Wiele
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18