title: Synchronous or metachronous lymphoma and metastatic cutaneous squamous cell carcinoma in the head and neck region: a diagnostic and management dilemma.
abstract: OBJECTIVE
  To review our experience of managing patients with a dual diagnosis of metastatic cutaneous squamous cell carcinoma in the head and neck region and low-grade non-Hodgkin lymphoma. The secondary aim was to evaluate the utility of 18F-fluorodeoxyglucose positron emission tomography during diagnosis.
  
  
  METHODS
  Patients diagnosed with metastatic cutaneous squamous cell carcinoma of the head and neck and low-grade non-Hodgkin lymphoma, in a five-year period, were identified. Patient, tumour and treatment characteristics were identified. 18F-fluorodeoxyglucose positron emission tomography imaging was reviewed and correlated with histopathology findings.
  
  
  RESULTS
  Eight patients were identified. There was a delay in diagnosis of metastatic squamous cell carcinoma in two patients. 18F-fluorodeoxyglucose positron emission tomography differentiated metastatic squamous cell carcinoma from low-grade non-Hodgkin lymphoma with a sensitivity of 88.2 per cent and a specificity of 94.7 per cent. In 38 per cent of patients, compromises in management had to be made.
  
  
  CONCLUSIONS
  The management of metastatic squamous cell carcinoma can be challenging in patients with low-grade non-Hodgkin lymphoma. 18F-fluorodeoxyglucose positron emission tomography can be useful in the diagnosis of metastatic squamous cell carcinoma in patients with low-grade non-Hodgkin lymphoma.
authors.affiliation: Department of Otolaryngology/ Head and Neck Surgery,Gosford,New South Wales,Australia.
authors.forename: I
authors.initials: I
authors.lastname: Kader
authors.affiliation: Department of Otolaryngology/ Head and Neck Surgery,Gosford,New South Wales,Australia.
authors.forename: B
authors.initials: B
authors.lastname: Leavers
authors.affiliation: Department of Otolaryngology/ Head and Neck Surgery,Gosford,New South Wales,Australia.
authors.forename: S
authors.initials: S
authors.lastname: Shashinder
authors.affiliation: Central Coast Clinical School,University of Newcastle,Gosford,New South Wales,Australia.
authors.forename: B
authors.initials: B
authors.lastname: Wylie
authors.affiliation: PRP Diagnostic Imaging,Gosford,New South Wales,Australia.
authors.forename: K-K
authors.initials: KK
authors.lastname: Chi
authors.affiliation: Sydney Medical School,University of Sydney,New South Wales,Australia.
authors.forename: P
authors.initials: P
authors.lastname: Sundaresan
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D049268:Positron-Emission Tomography
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Chronic Lymphocytic Leukemia; Head And Neck Cancer; Non-Hodgkin Lymphoma; Positron Emission Tomography; Skin Cancer; Squamous Cell Carcinoma