18F FDG Uptake Due to Late-Onset Osteoradionecrosis for Tongue Base Carcinoma

Differentiating osteoradionecrosis (ORN) from tumor recurrence is challenging. This report is rare documentation of false-positive 18F-FDG PET scan attributed to ORN in a patient previously treated for carcinoma of base of tongue (Ca BOT). Extraordinarily high 18F-FDG uptake was seen in right ramus (SUVmax, 17.4), left body mandible (SUVmax, 13.6) with left pleural deposits (SUVmax, 17.4). Tumor recurrence was suspected. Pleural fluid aspirate showed evidence of metastatic disease. However, CT-guided biopsy of mandibular lesions revealed necrotic tissue. Hence diagnosis of ORN was established. Patient was put on palliative chemotherapy. No mandibular recurrence was noted during 6-month follow-up period. Received for publication May 15, 2018; revision accepted December 24, 2018. Conflicts of interest and sources of funding: none declared. Author Declaration: The authors declare that the manuscript has not been published previously, and has been read and approved by all the authors, that the requirements for authorship as stated earlier in this document have been met, and that each author believes that the manuscript represents honest work. Correspondence to: Gurkaran Preet Singh, MDS, Department of Dental and Prosthetic Surgery, Room 217, Homi Bhabha Block, Tata Memorial Hospital, Dr E Borges Road, Parel, Mumbai, India. E-mail: gurkaranpreetsingh@gmail.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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