title: Interpretation of suspect head and neck fixations seen on PET/CT in lung cancer.
abstract: OBJECTIVE
  Smoking is the major risk factor for lung and head and neck cancer. The purpose of the present study was to determine the clinical impact of serendipitously revealed head and neck fixation on PET/CT in patients undergoing investigation for lung cancer.
  
  
  METHODS
  The reports from PET/CT studies for patients with lung cancer from September 2005 and April 2012 were retrospectively reviewed. Head and neck incidentaloma was interpreted as suggestive of second primary malignancy. These incidental findings were compared with the final diagnosis obtained from clinical and histological investigation.
  
  
  RESULTS
  Five hundred and ninety-two patients were investigated on PET/CT for lung cancer in the study period. PET/CT-positive head and neck lesions suggestive of second primary malignancy were found in 65 (11%) patients. Nasoendoscopy was performed in 23 patients and biopsy in 10. In 4 patients (17.4% of those explored), a second primary malignant lesion was proved on histology: 2 squamous cell carcinomas (larynx and oral cavity), 1 undifferentiated carcinoma (parotid), and 1 osteosarcoma (mandible). At a median 13 months' follow-up, 3 of the 4 patients with a second primary had died from disease-related causes and 1 was free of recurrence. Metastases from lung adenocarcinoma were found in 2 patients (0.34%).
  
  
  CONCLUSIONS
  PET/CT detected incidental head and neck malignant tumors in at least 0.68% of lung cancer patients, but in 6.4% of those with suspect head and neck fixation.
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France.
authors: Y
authors: Y
authors: Gobel
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France.
authors: G
authors: G
authors: Valette
authors: Service de médecine nucléaire, Centre hospitalier universitaire de Brest, Brest, France.
authors: R
authors: R
authors: Abgral
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France.
authors: C
authors: C
authors: Clodic
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France.
authors: E
authors: E
authors: Mornet
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France.
authors: G
authors: G
authors: Potard
authors: Service de médecine nucléaire, Centre hospitalier universitaire de Brest, Brest, France.
authors: P-Y
authors: PY
authors: Salaun
authors: Service d'ORL et chirurgie cervico-faciale, Hôpital Morvan, CHRU de Brest, 2, avenue Foch, 29200 Brest, France. Electronic address: remi.marianowski@chu-brest.fr.
authors: R
authors: R
authors: Marianowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Head and neck cancer; Incidentaloma; Lung cancer; PET/CT; Second malignancy