Kishino Takehito, Miyashita Takenori, Ouchi Yohei, Sogo Junko, Hoshikawa Hiroshi
Otolaryngology, Kagawa University, Kagawa, JPN.
Cureus. 2025 Aug 22;17(8):e90720. doi: 10.7759/cureus.90720. eCollection 2025 Aug.
For head and neck cancer, treatment efficacy and recurrence are often assessed by morphological imaging methods such as CT and MRI. However, these techniques are sometimes ineffective for distinguishing qualitative changes in tumors following treatment. Here, we report the case of a 50-year-old male patient who received chemoradiotherapy for head and neck squamous cell carcinoma with intracranial extension. Following treatment, the patient's symptoms subsided, and MRI at two and six months demonstrated tumor shrinkage. Six months after treatment, fluorodeoxyglucose (FDG) positron emission tomography (PET) revealed changes in the intracranial lesions, which were difficult to distinguish between tumor recurrence and necrosis. Consequently, we used 11C-methionine (MET) PET during follow-up. The findings from MET PET showed no evidence of disease recurrence; thus, the lesions were subsequently monitored for necrotic changes. This case suggests the potential utility of MET PET for differentiating recurrence from necrosis in head and neck cancers with intracranial extension. Further studies with larger cohorts are warranted to clarify its diagnostic accuracy and establish appropriate evaluation criteria.
对于头颈癌，治疗效果和复发情况通常通过CT和MRI等形态学成像方法进行评估。然而，这些技术有时在区分治疗后肿瘤的定性变化方面效果不佳。在此，我们报告一例50岁男性患者，其因颅内扩展的头颈鳞状细胞癌接受了放化疗。治疗后，患者症状缓解，治疗后2个月和6个月的MRI显示肿瘤缩小。治疗后6个月，氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）显示颅内病变有变化，难以区分肿瘤复发和坏死。因此，我们在随访期间使用了11C-蛋氨酸（MET）PET。MET PET的结果显示没有疾病复发的迹象；因此，随后对病变进行坏死变化监测。该病例表明MET PET在区分颅内扩展的头颈癌复发与坏死方面具有潜在应用价值。有必要进行更大样本量的进一步研究以阐明其诊断准确性并建立合适的评估标准。
