Positron Emission Tomography in Mucosal Melanomas of Head and Neck: Results from a South Asian Tertiary Cancer Care Center

To evaluate the accuracy of fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in staging and restaging of patients with mucosal melanomas (MM) of head and neck. Patients who underwent PET/CT at our institution, with a biopsy proven diagnosis of MM of the head and neck between March 2006 and December 2013 were included in the study. Nineteen patients with MM of the nasal cavity, paranasal sinuses, and oral cavity were included, of which 12 were for staging and seven for restaging. PET/CT had 100% sensitivity (SN), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) for detection of the primary. SN of 91.7%, SP of 100%, PPV of 100%, and NPV of 87.5% were seen for nodal metastases. For distant metastases, SN of 85.7%, SP of 100%, PPV of 100%, and NPV of 92.3% were noted. The disease was upstaged from loco-regional to metastatic in 32% leading to treatment change in 25% in the staging group and 43% in the restaging group. PET/CT demonstrates good overall accuracy in evaluation of patients with MM of the head and neck. The main strength of PET/CT lies in detection of distant metastatic disease due to extended whole-body field of view.