Usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base: comparison with FDG-PET

The patient was a 51-year-old man with repeated recurrent hemangiopericytoma in the skull base. We performed Choline-PET in this patient after various treatments and compared findings with those of FDG-PET.Choline accumulated in this tumor, but FDG did not accumulate. We diagnosed this tumor as residual hemangiopericytoma and performed the resection of the residual tumor. FDG-PET is not appropriate for skull base tumor detection because uptake in the brain is very strong.We emphasize the usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base after various treatments, compared with FDG-PET.Positron emission tomography (PET) has been successfully used for the diagnosis of head and neck cancer and 18-fluorodeoxyglucose (FDG) is the most commonly used PET tracer and FDG-PET offers the most effectiveness for imaging various tumors. However, this technique is not appropriate for skull base tumor detection because FDG uptake in the brain is very strong. Recently 11 C-choline was developed as a new PET tracer. Here we report the effectiveness of this tracer for PET imaging of residual hemangiopericytoma in the skull base. Hemangiopericytoma is a very rare tumor in the head and neck region. This tumor sometimes relapse in the base of skull. Repeated surgeries could cause severe postoperative complications. Therefore, accurate diagnosis of recurrent tumor is strongly required now.A 51-years-old Japanese man presented with a tumor in the right temple and underwent resection of the tumor at a medical college hospital in 1979. The histological diagnosis was hemangiopericytoma. Thereafter, he demonstrated local recurrence many times, underwent resection 5 times and embolization was performed 2 times. Despite these treatments, this tumor relapsed in the temple again and was treated by irradiation (total 61.8 Gy) in November 2002. However, the tumor appeared to persist and multiple lung metastases were detected. After 4 months, he consulted our