Opportunities for 2-[18F] Fluoro-2-Deoxy-D-Glucose PET/CT in Cervical-Vaginal Neuroendocrine Carcinoma: Case Series and Literature Review

다국어 초록 (Multilingual Abstract)

Objective: Neuroendocrine cervical carcinoma is a rare subtype of cervical cancer. These tumors exhibit an aggressive behavior with early regional lymph node and distant metastases. The purpose of our study was to describe five cases of neuroendocrine cervical-vaginal carcinoma and to discuss the potential of the 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan for the detection of this rare malignancy.
Materials and Methods: Five cases of cervical-vaginal neuroendocrine tumor were retrospectively collected, during a two year (from September 2009 to August 2011) period in our hospital. The clinical staging distributions were International Federation of Gynecology and Obstetrics (FIGO) stage IB2 (1 of 5), stage IIA (3 of 5) and stage IVA (1 of 5).
Results: Two cases (cases 1 and 4) were restaged after 18F-FDG PET/CT scan in the initial staging process. Post-treatment 18F-FDG PET/CT scans, in three patients, revealed positive findings for tumor recurrence or lymph node metastases. Two patients (cases 2 and 3) died of tumor within two years.
Conclusion: 18F-FDG PET/CT scan is a useful tool in cervical-vaginal neuroendocrine tumor. In its initial staging, the 18F-FDG PET/CT scan may help assess the possible nodal involvement or early hematogeneous spreading. We can also use the 18F-FDG PET/CT to detect local recurrence and to evaluate the treatment response after clinical manipulation.

다국어 초록 (Multilingual Abstract)

Objective: Neuroendocrine cervical carcinoma is a rare subtype of cervical cancer. These tumors exhibit an aggressive behavior with early regional lymph node and distant metastases. The purpose of our study was to describe five cases of neuroendocrine cervical-vaginal carcinoma and to discuss the potential of the 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan for the detection of this rare malignancy.
Materials and Methods: Five cases of cervical-vaginal neuroendocrine tumor were retrospectively collected, during a two year (from September 2009 to August 2011) period in our hospital. The clinical staging distributions were International Federation of Gynecology and Obstetrics (FIGO) stage IB2 (1 of 5), stage IIA (3 of 5) and stage IVA (1 of 5).
Results: Two cases (cases 1 and 4) were restaged after 18F-FDG PET/CT scan in the initial staging process. Post-treatment 18F-FDG PET/CT scans, in three patients, revealed positive findings for tumor recurrence or lymph node metastases. Two patients (cases 2 and 3) died of tumor within two years.
Conclusion: 18F-FDG PET/CT scan is a useful tool in cervical-vaginal neuroendocrine tumor. In its initial staging, the 18F-FDG PET/CT scan may help assess the possible nodal involvement or early hematogeneous spreading. We can also use the 18F-FDG PET/CT to detect local recurrence and to evaluate the treatment response after clinical manipulation.

참고문헌 (Reference)

1 Yen TC, "Value of dual-phase 2-fluoro-2-deoxy-d-glucose positron emission tomography in cervical cancer" 21 : 3651-3658, 2003

2 Trinh XB, "Treatment policy of neuroendocrine small cell cancer of the cervix" 25 : 40-44, 2004

3 Unger JB, "The prognostic value of pretreatment 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography scan in women with cervical cancer" 17 : 1062-1067, 2007

4 Nakamura K, "The predictive value of measurement of SUVmax and SCC-antigen in patients with pretreatment of primary squamous cell carcinoma of cervix" 119 : 81-86, 2010

5 Henriksen E, "The lymphatic spread of carcinoma of the cervix and of the body of the uterus; a study of 420 necropsies" 58 : 924-942, 1949

6 Albores-Saavedra J, "Terminology of endocrine tumors of the uterine cervix: results of a workshop sponsored by the College of American Pathologists and the National Cancer Institute" 121 : 34-39, 1997

7 Chung HH, "Preoperative [18F]FDG PET/CT maximum standardized uptake value predicts recurrence of uterine cervical cancer" 37 : 1467-1473, 2010

8 Reig Castillejo A, "Neuroendocrine small cell carcinoma of the uterine cervix" 12 : 512-513, 2010

9 Wang KL, "Neuroendocrine carcinoma of the uterine cervix: a clinicopathologic retrospective study of 31 cases with prognostic implications" 18 : 209-216, 2006

10 Jhingran A, "Malignagnt diseases of the cervix: microinvasive and invasive carcinoma: diagnosis and management, In Comprehensive Gynecology, 5th ed" Mosby Elsevier 2007

11 Yang DH, "MRI of small cell carcinoma of the uterine cervix with pathologic correlation" 182 : 1255-1258, 2004

12 Okamoto Y, "MR imaging of the uterine cervix: imaging-pathologic correlation" 23 : 425-445, 2003

13 Krivak TC, "Large cell neuroendocrine cervical carcinoma: a report of two cases and review of the literature" 82 : 187-191, 2001

14 Sato Y, "Large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathological study of six cases" 22 : 226-230, 2003

15 Yilmaz M, "FDG PET-CT in cervical cancer: relationship between primary tumor FDG uptake and metastatic potential" 31 : 526-531, 2010

16 McCusker ME, "Endocrine tumors of the uterine cervix: incidence, demographics, and survival with comparison to squamous cell carcinoma" 88 : 333-339, 2003

17 Oberg K, "Current knowledge on diagnosis and staging of neuroendocrine tumors" 30 (30): 3-7, 2011

18 Pallardy A, "Clinical and survival impact of FDG PET in patients with suspicion of recurrent cervical carcinoma" 37 : 1270-1278, 2010

19 Waggoner SE, "Cervical cancer" 361 : 2217-2225, 2003

20 Belhocine TZ, "18F-FDG PET imaging in posttherapy monitoring of cervical cancers: from diagnosis to prognosis" 45 : 1602-1604, 2004