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Teflon laryngeal granuloma presenting as laryngeal cancer on combined positron emission tomography and computed tomography scanning

Published online by Cambridge University Press:  31 October 2008

M P Ondik ,
J Kang ,
M G Bayerl ,
M Bruno  and
D Goldenberg
M P Ondik
Affiliation:
Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
J Kang
Affiliation:
Department of Pathology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
M G Bayerl
Affiliation:
Department of Pathology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
M Bruno
Affiliation:
Department of Radiology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
D Goldenberg*
Affiliation:
Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
*
Address for correspondence: Dr David Goldenberg, Penn State Hershey Medical Center, 500 University Drive, MCH091, Hershey, PA 17033-0850, USA. Fax: +1 717 531 6160 E-mail: dgoldenberg@hmc.psu.edu.
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Abstract

Background:

Positron emission tomography with 18F-fluorodeoxyglucose (18FDG) has been increasingly used in the diagnostic investigation of patients with neoplasms of the head and neck. Positron emission tomography and computed tomography have also proven useful for surveillance of thyroid cancers that no longer concentrate radioiodine. However, certain benign or inflammatory lesions can also accumulate 18F-fluorodeoxyglucose and lead to misdiagnosis.

Objectives:

We review and discuss the pitfalls of using positron emission tomography and computed tomography for surveillance of thyroid cancer.

Method:

We present the case of a 48-year-old woman who was diagnosed with a laryngeal neoplasm on integrated positron emission tomography and computed tomography scanning, after a routine ultrasound demonstrated an enlarged thyroid nodule. On physical examination, she had a laryngeal mass overlying an immobile vocal fold. The mass was biopsied and found to harbour a Teflon granuloma.

Conclusions:

Positron emission tomography positive Teflon granulomas have previously been reported in the nasopharynx and vocal folds, and should be considered in the differential diagnosis of patients who have undergone prior surgery involving Teflon injection. It is important for otolaryngologists and radiologists to recognise potential causes of false positive positron emission tomography and computed tomography findings, including Teflon granulomas.

Keywords

PolytetrafluoroethyleneGranulomaPositron Emission TomographyThyroid GlandVocal Cord ParalysisLarynx Neoplasms
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , pp. 575 - 578
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the 2008 Annual Scientific Meeting of the Pennsylvania Academy of Otolaryngology Head and Neck Surgery, in Bedford Springs, Pennsylvania, USA, June 13-14, 2008.

References

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