PET/CT Detection of Epstein-Barr Virus-Positive Lacrimal Sac Carcinoma in Unknown Primary Cervical Nodal Metastasis.
case_report · Level V
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- Record sourced from PubMed, PMID 40734203.
- Also identified by DOI 10.1097/RLU.0000000000006079.
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Abstract
A 55-year-old man presented with a left submandibular mass. Biopsy revealed metastatic carcinoma, later confirmed by immunohistochemistry as Epstein-Barr virus (EBV)-positive nonkeratinizing squamous cell carcinoma, possibly of nasopharyngeal or pulmonary origin. Despite elevated serum EBV-DNA (79.1 copies/mL), nasopharyngeal endoscopy and biopsies were normal. 18 F-FDG PET/CT revealed an FDG-avid nodule in the left lacrimal sac and hypermetabolic cervical nodes. Surgical resection confirmed EBV-encoded RNA (EBER)-positive undifferentiated carcinoma in the lacrimal sac and metastasis in lymph nodes. This case highlights the lacrimal sac as a rare primary site of EBV-associated carcinoma and the utility of 18 F-FDG PET/CT in detecting occult primaries.
Medical subject headings
- Positron Emission Tomography Computed Tomography
- Herpesvirus 4, Human
- Neoplasms, Unknown Primary
- Lacrimal Apparatus