Elevated 18F-NaF uptake in cricoid cartilage in a patient with laryngeal carcinoma

Abstract

Rationale:Laryngeal cancer is aggressive tumor that arises from the tissues of the larynx. Although any bone can be affected, involvement of cricoid cartilage was reported very rarely, and there has been no report of 18F-sodium fluoride positron emission tomography-computed tomography (18F-NaF PET-CT) and 3D PET-CT for the evaluation of cricoid cartilage invasion.Patient concerns:A 54-year-old male discovered a protruding mass in the right anterior neck, which had rapidly increased in size over a period of 2 months. Subsequently, hoarseness, dysphagia, and dyspnea were gradually developed.Diagnoses:18F-FDG PET-CT demonstrated that the abnormal activity was located in a soft tissue mass, which was about 4.2 cm × 3.8 cm × 3.6 cm in largest dimension in the laryngeal cavity of supraglottic portion (SUVmax: 23.6). A swollen lymph node was revealed in the right submandibular region, which had intense FDG activity with a SUVmax of 18.4. However, there is a high uptake of 18F-FDG in the region near the bone, which is uncertain whether there is any skeletal invasion. NaF PET-CT and 3D PET-CT demonstrated increased uptake in the right side of cricoid cartilage (SUVmax: 13.2). The histopathologic examination confirmed squamous cell carcinoma of larynx.Interventions:The patient underwent tracheotomy and received anti-infective treatment to relieve symptoms of dyspnea and prevent asphyxia.Outcomes:Clinical follow up of the patient revealed that dyspnea was significantly relieved.Lessons:The case report shows the imaging features of cricoid cartilage invasion, including 18F-FDG PET/CT, 18F-sodium fluoride positron emission tomography-computed tomography (18F-NaF PET-CT), and 3D PET-CT. Precise understanding of the invasion scope, accurately staging of laryngeal carcinoma, and choosing of the most suitable surgical scheme are the factors that lead to the optimal treatment of laryngeal neoplasms.

Metastatic sigmoid adenocarcinoma to the larynx: A case report and updated literature review

“…13,14 Incidental laryngeal metastasis without symptoms is also evident, as reported by Xia et al when a PET/CT (Positron Emission Tomography/Computed Topography) was performed for an elevated AFP (Alfa Fetoprotein) which showed increased uptake in the larynx. 15…”

Metastatic sigmoid adenocarcinoma to the larynx: a case report and updated literature review

“…(13,14) Incidental laryngeal metastasis without symptoms is also evident, as reported by Xia et al when a PET CT (positron emission tomography-computed scan) was done for an elevated AFP (Alfa fetoprotein) showed increased uptake in the larynx. (15) CONCLUSION Any laryngeal lesion in patients with malignancy or high-risk factors for malignancy should be worked out promptly to avoid any delay in diagnosis and management; even though secondary laryngeal malignancy is rare, micro-metastasis and subclinical disease is evident; however, laryngeal cancer metastasis indicates advance disease and poor prognosis, but intervention aims to avoid any respiratory distress or direct mortality from airway obstruction.…”

Down-regulation of SOX18 inhibits laryngeal carcinoma cell proliferation, migration, and invasion through JAK2/STAT3 signaling

“…Laryngeal carcinoma is one of the most common malignant tumors among people with a history of head and neck tumors. The overall incidence of laryngeal cancer has remarkably increased and has become the second most common cancer of respiratory system [1,2]. Most of the laryngeal carcinomas develop from squamous cells and thus referred to as squamous cell carcinomas.…”