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Synchronous or metachronous lymphoma and metastatic cutaneous squamous cell carcinoma in the head and neck region: a diagnostic and management dilemma

Published online by Cambridge University Press:  04 August 2016

I Kader*
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia
B Leavers
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia
S Shashinder
Affiliation:
Department of Otolaryngology/ Head and Neck Surgery, Gosford, New South Wales, Australia Central Coast Clinical School, University of Newcastle, Gosford, New South Wales, Australia
B Wylie
Affiliation:
Central Coast Clinical School, University of Newcastle, Gosford, New South Wales, Australia Department of Haematology, Gosford Hospital, Gosford, New South Wales, Australia
K-K Chi
Affiliation:
PRP Diagnostic Imaging, Gosford, New South Wales, Australia
P Sundaresan
Affiliation:
Sydney Medical School, University of Sydney, New South Wales, Australia
*
Address for correspondence: Dr Imran Kader, Department of Otolaryngology/ Head and Neck Surgery, Gosford Hospital, 10 Holden Street, Gosford, NSW 2250, Australia Fax: +61 2 4320 3860 E-mail: [email protected]

Abstract

Objective:

To review our experience of managing patients with a dual diagnosis of metastatic cutaneous squamous cell carcinoma in the head and neck region and low-grade non-Hodgkin lymphoma. The secondary aim was to evaluate the utility of 18F-fluorodeoxyglucose positron emission tomography during diagnosis.

Methods:

Patients diagnosed with metastatic cutaneous squamous cell carcinoma of the head and neck and low-grade non-Hodgkin lymphoma, in a five-year period, were identified. Patient, tumour and treatment characteristics were identified. 18F-fluorodeoxyglucose positron emission tomography imaging was reviewed and correlated with histopathology findings.

Results:

Eight patients were identified. There was a delay in diagnosis of metastatic squamous cell carcinoma in two patients. 18F-fluorodeoxyglucose positron emission tomography differentiated metastatic squamous cell carcinoma from low-grade non-Hodgkin lymphoma with a sensitivity of 88.2 per cent and a specificity of 94.7 per cent. In 38 per cent of patients, compromises in management had to be made.

Conclusion:

The management of metastatic squamous cell carcinoma can be challenging in patients with low-grade non-Hodgkin lymphoma. 18F-fluorodeoxyglucose positron emission tomography can be useful in the diagnosis of metastatic squamous cell carcinoma in patients with low-grade non-Hodgkin lymphoma.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Andruchow, JL, Veness, MJ, Morgan, GJ, Gao, K, Clifford, A, Shannon, KF et al. Implications for clinical staging of metastatic cutaneous squamous carcinoma of the head and neck based on a multicenter study of treatment outcomes. Cancer 2006;106:1078–83Google Scholar
2 Hartley, BE, Searle, AE, Breach, NM, Rhys-Evans, PH, Henk, JM. Aggressive cutaneous squamous cell carcinoma of the head and neck in patients with chronic lymphocytic leukaemia. J Laryngol Otol 1996;110:694–5CrossRefGoogle ScholarPubMed
3 Moore, MG, Bhattacharyya, N. Survival outcomes for head and neck squamous cell carcinoma arising after lymphoma. Otolaryngol Head Neck Surg 2008;138:388–93Google Scholar
4 Forest, VI, Clark, JJ, Veness, MJ, Milross, C. N1S3: a revised staging system for head and neck cutaneous squamous cell carcinoma with lymph node metastases: results of 2 Australian Cancer Centers. Cancer 2010;116:1298–304Google Scholar
5 Vauterin, TJ, Veness, MJ, Morgan, GJ, Poulsen, MG, O'Brien, CJ. Patterns of lymph node spread of cutaneous squamous cell carcinoma of the head and neck. Head Neck 2006;28:785–91CrossRefGoogle ScholarPubMed
6 Flezar, MS, Prevodnik, VK, Kirbis, IS, Strojan, P. Cutaneous squamous cell carcinoma metastatic to chronic lymphocytic leukaemia: diagnostic potential of fine needle aspiration cytology. Cytopathology 2006;17:288–94Google Scholar
7 Stokkel, MP, Moons, KG, ten Broek, FW, van Rijk, PP, Hordijk, GJ. 18 F-fluorodeoxyglucose dual-head positron emission tomography as a procedure for detecting simultaneous primary tumors in cases of head and neck cancer. Cancer 1999;86:2370–7Google Scholar
8 Robbins, KT, Clayman, G, Levine, PA, Medina, J, Sessions, R, Shaha, A et al. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 2002;128:751–8CrossRefGoogle ScholarPubMed
9 Levi, F, Randimbison, L, Te, VC, La Vecchia, C. Non-Hodgkin's lymphomas, chronic lymphocytic leukaemias and skin cancers. Br J Cancer 1996;74:1847–50CrossRefGoogle ScholarPubMed
10 Kristinsson, SY, Dickman, PW, Wilson, WH, Caporaso, N, Bjorkholm, M, Landgren, O. Improved survival in chronic lymphocytic leukemia in the past decade: a population-based study including 11,179 patients diagnosed between 1973–2003 in Sweden. Haematologica 2009;94:1259–65CrossRefGoogle Scholar
11 Asaumi, J, Yanagi, Y, Konouchi, H, Hisatomi, M, Matsuzaki, H, Kishi, K. Application of dynamic contrast-enhanced MRI to differentiate malignant lymphoma from squamous cell carcinoma in the head and neck. Oral Oncol 2004;40:579–84Google Scholar
12 Tomaszewski, JM, Lau, E, Corry, J. Utility of positron emission tomography/computed tomography for nodal staging of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia. Am J Otolaryngol 2014;35:66–9CrossRefGoogle ScholarPubMed
13 Watanabe, N, Inohara, H, Akahani, S, Yamamoto, Y, Moriwaki, K, Kubo, T. Synchronous squamous cell carcinoma and malignant lymphoma in the head and neck region. Auris Nasus Larynx 2007;34:273–6CrossRefGoogle ScholarPubMed
14 Millwaters, M, Khan, N, Halfpenny, W. Simultaneous lymphoma and squamous cell carcinoma presenting as a neck lump. Br J Oral Maxillofac Surg 2008;46:144–5CrossRefGoogle ScholarPubMed