Abstract
Non-keratinizing squamous cell carcinoma (NKSCC) of the lacrimal apparatus is extremely rare. It is usually very aggressive in destroying local tissue and has a grave prognosis for relentless recurrence and distant failures. Though the current evidence cannot make confident recommendations regarding the best management, curative surgical excision with adjuvant radiotherapy remains the most commonly used strategy. Here, we report a 71-year-old woman presented with progressive right medial canthal swellings for six months. A transnasal endoscopic biopsy revealed NKSCC of the lacrimal sac. She then underwent a combination of magnetic resonance images (MRI) and 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) for staging purposes. Following cisplatin-based concurrent chemo-radiotherapy (CCRT), the post-treatment PET/CT illustrated the absence of an abnormal metabolic accumulation over the suspicious region as observed in post-treatment CT. A further trans-ostia re-biopsy confirmed complete tumor remission. This case demonstrates the remarkable ability of 18F-FDG PET/CT to differentiate between a persistent malignancy and post-treatment changes. Furthermore, a definite CCRT might provide comparable outcomes to traditional surgery.
Highlights
We identified ab-within the (C,G); fused PET/CT: (D,H); lesion annotated by arrows). (D) We identified abnormal F-FDG accumulations normal 18F-FDG accumulations within the lacrimal apparatus, paranasal sinus, and extra-conal orlacrimal apparatus, paranasal sinus, and extra-conal orbital compartment, with a maximal standardized uptake value of 11.5
[2,5], hidden anatomic location, lacrimal sac Non-keratinizing squamous cell carcinoma (NKSCC) usually presents with an insidious course and but the vague unfavorable, symptoms, thereby in early-stage diagnosis
We illustrate how cisplatin-based concurrent chemo-radiotherapy (CCRT) may act as an effective ease-free status for 23 months on follow up
Summary
Concurrent Chemoradiotherapy. Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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