Fluorodeoxyglucose positron emission tomography in cutaneous squamous cell carcinoma: retrospective analysis of 12 patients.

Background: Whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has been used for whole-body imaging modality in detecting malignancy in clinical oncology. However, only a few reports of FDG PET in skin cancers have been described, except for melanoma and lymphoma.

Objective: To report on the usefulness of FDG PET as a baseline workup study for patients with cutaneous squamous cell carcinoma (SCC).

Methods: There were 12 cases of SCC (9 cases with high-risk SCC). Of the 12, FDG PET was performed for staging in 11 patients and for restaging in 1 patient 1 year after wide excision.

Results: Primary lesions were detected in nine cases (83.3%), lymph node involvement in three cases (25.0%), and distant. organ (lung) involvement in one case (8.3%). In one patient whose primary lesion was positive, stomach cancer with involvement of adrenal glands, omentum, and lymph nodes was incidentally detected. All of the patients with high-risk SCC showed FDG uptakes of the primary lesions, and the patients with FDG uptakes in lymph nodes and distant organ had high-risk SCC.

Conclusion: There have been no comparative studies on the cost-effectiveness between sentinel lymph node biopsy and FDG PET in SCC patients. However, considering the noninvasiveness and thoroughness in checking the whole body, including distant organs, FDG PET may have clinical value as a baseline workup study for patients with high-risk SCC.