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. Author manuscript; available in PMC: 2013 Oct 1.
Published in final edited form as: Imaging Med. 2012 Dec;4(6):633–647. doi: 10.2217/iim.12.60

Figure 2. Glottic squamous cell carcinoma, stage T4aN2bM0.

Figure 2

A 49-year-old male presenting with hoarseness and weight loss. Direct inspection showed irregular appearing laryngeal mucosa, concerning for malignancy. The biopsy was consistent with squamous cell carcinoma, stage T4aN2bM0. The patient expired, despite treatment with neoadjuvant chemoratiation therapy. Staging PET/CT (A) maximum intensity projection (B) fused PET/CT images demonstrate an area of intense metabolic activity (standardized uptake value normalized to lean body mass of 8.7 and maximum standardized uptake value of 10.9) corresponding to an infiltrating soft tissue lesion involving both vocal cords and extending from the epiglottis down to the thyroid cartilage, consistent with a primary tumor. In addition, focal 18F-fluoro-2-deoxyglucose uptake is noted in the right neck (standardized uptake value normalized to lean body mass of 4.0 and maximum standardized uptake value of 4.2) fusing to metastatic lymphadenopathy, levels 2 and 4. (C) Fused CT and volumetric PET images (standardized uptake value normalized to lean body mass of 3.0 threshold) shows large primary metabolic tumor volume (32.9 ml) with measurable node volume of 0.9 ml.