Incidental detection of oropharyngeal cancer with fluciclovine PET

BACKGROUND: Fluorine-18-labeled 1-amino-3-fluorocyclobutane-1-carboxylic acid (fluciclovine) is a synthetic amino acid radiopharmaceutical initially developed to improve noninvasive diagnosis of gliomas and currently FDA approved for prostate cancer imaging. Although fluciclovine positron emission tomography (PET) has proven to be efficacious in detecting multiple types of cancer, its ability to detect oropharyngeal squamous cell carcinoma (OPSCC) is largely unknown. METHODS: We describe a case of incidental OPSCC detection with fluciclovine PET in a 66-year old male patient during workup for recurrent prostate adenocarcinoma. RESULTS: Fluciclovine PET detected a left base of tongue (BOT) lesion, which was subsequently confirmed as invasive SCC on surgical pathology. CONCLUSION: Given these findings, we discuss potential future directions for research with fluciclovine to overcome some of the known limitations of 18 [F]fluorodeoxyglucose in oncological imaging.