Spontaneous rupture of hepatocellular carcinoma(HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extr...Spontaneous rupture of hepatocellular carcinoma(HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extrahepatic metastasis of HCC has been advocated to obtain a possibility of long-term survival. However, it is a challenge for clinicians to detect implantation metastasis of spontaneously ruptured HCC. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection. 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography/computed tomography(PET/CT) is useful in detecting intraabdominal implantation metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in determining the location of metastasis. We present one patient with a new isolated pelvic implantation metastasis detected by 18F-FDG PET/CT and pathologically confirmed by PET/CT-guided percutaneous biopsy, who had a history of resection of spontaneously ruptured HCC two years ago. The patient's condition was stable at the 6-mo follow-up after resection of the isolated pelvic metastasis.展开更多
Aim:Lymph node(LN)metastases are associated with poor outcomes in patients with recurrent larynx squamous cell carcinoma(LSCC).Neck dissection(ND)is therefore commonly performed along with salvage total laryngectomy(S...Aim:Lymph node(LN)metastases are associated with poor outcomes in patients with recurrent larynx squamous cell carcinoma(LSCC).Neck dissection(ND)is therefore commonly performed along with salvage total laryngectomy(STL).Here,we assess the rate of occult LN metastases and the diagnostic value of MRI and PET/CT for detecting them in recurrent LSCC.Methods:This retrospective study included patients with recurrent LSCC after primary(chemo)radiotherapy[(C)RT]who were re-staged by MRI and/or PET/CT and treated with STL and ND between 2004 and 2019.The histopathology of ND samples was used as the reference standard.Results:Forty-one patients were included.The prevalence of occult metastases in MRI-negative and PET/CT-negative neck nodes was between 3.2%and 6.1%.Negative predictive values of neck node re-staging were 93.9%for MRI,96.8%for PET/CT,and 96.2%for MRI and PET/CT combined.Conclusion:Both MRI and PET/CT afforded good negative predictive values for nodal staging in patients with recurrent LSCC after(C)RT prior to STL.In selected patients,these radiological modalities,particularly PET/CT,could help to avoid unnecessary surgery to the neck and its associated morbidity.展开更多
基金Supported by National Science Foundation for Yong Scholars of China,No.81101067
文摘Spontaneous rupture of hepatocellular carcinoma(HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extrahepatic metastasis of HCC has been advocated to obtain a possibility of long-term survival. However, it is a challenge for clinicians to detect implantation metastasis of spontaneously ruptured HCC. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection. 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography/computed tomography(PET/CT) is useful in detecting intraabdominal implantation metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in determining the location of metastasis. We present one patient with a new isolated pelvic implantation metastasis detected by 18F-FDG PET/CT and pathologically confirmed by PET/CT-guided percutaneous biopsy, who had a history of resection of spontaneously ruptured HCC two years ago. The patient's condition was stable at the 6-mo follow-up after resection of the isolated pelvic metastasis.
文摘Aim:Lymph node(LN)metastases are associated with poor outcomes in patients with recurrent larynx squamous cell carcinoma(LSCC).Neck dissection(ND)is therefore commonly performed along with salvage total laryngectomy(STL).Here,we assess the rate of occult LN metastases and the diagnostic value of MRI and PET/CT for detecting them in recurrent LSCC.Methods:This retrospective study included patients with recurrent LSCC after primary(chemo)radiotherapy[(C)RT]who were re-staged by MRI and/or PET/CT and treated with STL and ND between 2004 and 2019.The histopathology of ND samples was used as the reference standard.Results:Forty-one patients were included.The prevalence of occult metastases in MRI-negative and PET/CT-negative neck nodes was between 3.2%and 6.1%.Negative predictive values of neck node re-staging were 93.9%for MRI,96.8%for PET/CT,and 96.2%for MRI and PET/CT combined.Conclusion:Both MRI and PET/CT afforded good negative predictive values for nodal staging in patients with recurrent LSCC after(C)RT prior to STL.In selected patients,these radiological modalities,particularly PET/CT,could help to avoid unnecessary surgery to the neck and its associated morbidity.
