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Head and Neck Cancer

History: Malignant right neck mass. History of renal cell carcinoma. Staging.

Impression:

  1. FDG-avid lesions in the subcutaneous tissues of the right neck along with 2 FDG-avid lesions in the liver. These findings are suspicious for renal cell carcinoma metastatic disease.
  2. Non-FDG-avid lytic lesion in the T1 vertebral body which could be degenerative in nature, however metastatic disease is not ruled out.
  3. 4 mm lung nodule which is too small to be characterized by PET. This could be secondary to granulomatous disease, however follow up CT in 6 months to document stability should be considered.
Clinical Utility:  Combined PET-CT is more accurate than PET alone or CT alone for the depiction of malignancy in the head and neck (May 2005 Radiology, 235, 580-586).
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