False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck
Background: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various b...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/2227-9067/11/3/348 |
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| author | Yuta Matsumoto Motohiro Matsui Akari Makidono Atsushi Makimoto Yuki Yuza |
| author_facet | Yuta Matsumoto Motohiro Matsui Akari Makidono Atsushi Makimoto Yuki Yuza |
| author_sort | Yuta Matsumoto |
| collection | DOAJ |
| description | Background: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various benign conditions. Case summary: A 5-year-old male patient with a malignant rhabdoid tumor originating in the left neck underwent primary tumor resection concurrently with ipsilateral lymph node dissection after receiving neoadjuvant chemotherapy consisting of cyclophosphamide, carboplatin, etoposide, vincristine, and doxorubicin. He later received the same adjuvant chemotherapy as well as proton therapy for the primary tumor. Sixteen months after completing the initial therapy, follow-up PET-CT revealed a novel area of glucose hypermetabolism in the right side of the tongue, which was suspected of being a recurrence. However, a physical examination and magnetic resonance imaging (MRI) demonstrated no evidence of tumor recurrence. The patient had a significant leftward deviation of the tongue, suggesting left hypoglossal nerve paralysis. Denervation of the ipsilateral intrinsic tongue muscles secondary to the treatment had caused atrophy in the ipsilateral muscles and compensatory hypertrophy in the contralateral muscles, which increased FDG uptake. Physicians should carefully confirm any diagnosis of a locally recurrent tumor because PET-CT often produces ambiguous findings. |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-04-24T18:25:22Z |
| publishDate | 2024-03-01 |
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| spelling | doaj.art-2a057dff130849e797e9a8cddb895ee22024-03-27T13:31:12ZengMDPI AGChildren2227-90672024-03-0111334810.3390/children11030348False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the NeckYuta Matsumoto0Motohiro Matsui1Akari Makidono2Atsushi Makimoto3Yuki Yuza4Department of General Pediatrics, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, JapanDepartment of Pediatric Hematology Oncology, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, JapanDepartment of Radiology, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, JapanDepartment of Pediatric Hematology Oncology, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, JapanDepartment of Pediatric Hematology Oncology, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, JapanBackground: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various benign conditions. Case summary: A 5-year-old male patient with a malignant rhabdoid tumor originating in the left neck underwent primary tumor resection concurrently with ipsilateral lymph node dissection after receiving neoadjuvant chemotherapy consisting of cyclophosphamide, carboplatin, etoposide, vincristine, and doxorubicin. He later received the same adjuvant chemotherapy as well as proton therapy for the primary tumor. Sixteen months after completing the initial therapy, follow-up PET-CT revealed a novel area of glucose hypermetabolism in the right side of the tongue, which was suspected of being a recurrence. However, a physical examination and magnetic resonance imaging (MRI) demonstrated no evidence of tumor recurrence. The patient had a significant leftward deviation of the tongue, suggesting left hypoglossal nerve paralysis. Denervation of the ipsilateral intrinsic tongue muscles secondary to the treatment had caused atrophy in the ipsilateral muscles and compensatory hypertrophy in the contralateral muscles, which increased FDG uptake. Physicians should carefully confirm any diagnosis of a locally recurrent tumor because PET-CT often produces ambiguous findings.https://www.mdpi.com/2227-9067/11/3/348combined positron emission tomography–computed tomographyPET-CTmalignant rhabdoid tumorfalse-positive 18F-fluorodeoxyglucose uptake |
| spellingShingle | Yuta Matsumoto Motohiro Matsui Akari Makidono Atsushi Makimoto Yuki Yuza False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck Children combined positron emission tomography–computed tomography PET-CT malignant rhabdoid tumor false-positive 18F-fluorodeoxyglucose uptake |
| title | False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck |
| title_full | False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck |
| title_fullStr | False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck |
| title_full_unstemmed | False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck |
| title_short | False-Positive Asymmetrical Tongue Muscle 18F-FDG Uptake in Hypoglossal Nerve Paralysis Following Lymph Node Dissection in a Pediatric Patient with Malignant Rhabdoid Tumor of the Neck |
| title_sort | false positive asymmetrical tongue muscle 18f fdg uptake in hypoglossal nerve paralysis following lymph node dissection in a pediatric patient with malignant rhabdoid tumor of the neck |
| topic | combined positron emission tomography–computed tomography PET-CT malignant rhabdoid tumor false-positive 18F-fluorodeoxyglucose uptake |
| url | https://www.mdpi.com/2227-9067/11/3/348 |
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