Incidental detection of oropharyngeal cancer with fluciclovine PET

Abstract

Background Fluorine‐18‐labeled 1‐amino‐3‐fluorocyclobutane‐1‐carboxylic acid (fluciclovine) is a synthetic amino acid radiopharmaceutical initially developed to improve noninvasive diagnosis of gliomas and currently FDA approved for prostate cancer imaging. Although fluciclovine positron emission tomography (PET) has proven to be efficacious in detecting multiple types of cancer, its ability to detect oropharyngeal squamous cell carcinoma (OPSCC) is largely unknown. Methods We describe a case of incidental OPSCC detection with fluciclovine PET in a 66‐year old male patient during workup for recurrent prostate adenocarcinoma. Results Fluciclovine PET detected a left base of tongue (BOT) lesion, which was subsequently confirmed as invasive SCC on surgical pathology. Conclusion Given these findings, we discuss potential future directions for research with fluciclovine to overcome some of the known limitations of 18[F]fluorodeoxyglucose in oncological imaging.

Incidental Uptake of 18F-Fluciclovine by Type AB Thymoma

“…Hence, the tumor was best classified as type AB (type B2 for the B component) with coexisting type B3. Because its approval for detection of recurrent prostate cancer, 18 F-fluciclovine has demonstrated focal uptake in many nonprostatic neoplasms among various organ systems 1–8 . Uptake can also occur in benign infectious and inflammatory processes, such as prostatic hyperplasia, osteoid osteomas, and acute appendicitis 9–12 .…”

“…Because its approval for detection of recurrent prostate cancer, 18 F-fluciclovine has demonstrated focal uptake in many nonprostatic neoplasms among various organ systems. [1][2][3][4][5][6][7][8] Uptake can also occur in benign infectious and inflammatory processes, such as prostatic hyperplasia, osteoid osteomas, and acute appendicitis. 9-12 A recent report by Robertson et al 13 presents a case of 18 F-fluciclovine uptake in a thymoma, and Fallanca et al 14 present a thymoma picked up incidentally on 11 C-choline PET/CT.…”