Head & neck · 2026
Intraoperative Molecular Imaging Can Detect Large Nerve Perineural Invasion: A Case Report.
Клинический случайСтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Burns Carleigh R, Mattingly Aviva S, Ely Kim, Radevic Andreja, Meeks Nicole, Zaidi Sydea Maria Ahmad, Brown Brandee, Vasiukov Georgii, Topf Michael, Rosenthal Eben
Аннотация
BACKGROUND: Perineural invasion (PNI) in head and neck squamous cell carcinoma (SCC) results in worse overall survival. Diagnosis requires resection and microscopic evaluation.
METHODS: A 63-year-old male with persistent cT4aN0 p16-positive SCC of the left base of tongue following chemoradiotherapy underwent salvage total glossectomy. Fluorescence-guided imaging of the wound bed was performed with PDE-GEN3 near-infrared (NIR) imaging following infusion of an optically EGFR-targeted antibody, Panitumumab-IRDye800 (pan800).
RESULTS: The proximal resected hypoglossal nerve was imaged intraoperatively and demonstrated a strong green fluorescence signal, raising concern for subclinical PNI. Biopsy of the nerve revealed SCC on frozen section analysis. This was re-resected with subsequent proximal margin negative for carcinoma. Postoperatively, ex vivo imaging of the nerve using PDE-GEN3 NIR imaging again demonstrated the presence of pan800 within the initial positive nerve margin, confirming subclinical PNI.
CONCLUSIONS: This case shows the feasibility of intraoperative fluorescence as a method to help identify subclinical PNI.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05945875.
METHODS: A 63-year-old male with persistent cT4aN0 p16-positive SCC of the left base of tongue following chemoradiotherapy underwent salvage total glossectomy. Fluorescence-guided imaging of the wound bed was performed with PDE-GEN3 near-infrared (NIR) imaging following infusion of an optically EGFR-targeted antibody, Panitumumab-IRDye800 (pan800).
RESULTS: The proximal resected hypoglossal nerve was imaged intraoperatively and demonstrated a strong green fluorescence signal, raising concern for subclinical PNI. Biopsy of the nerve revealed SCC on frozen section analysis. This was re-resected with subsequent proximal margin negative for carcinoma. Postoperatively, ex vivo imaging of the nerve using PDE-GEN3 NIR imaging again demonstrated the presence of pan800 within the initial positive nerve margin, confirming subclinical PNI.
CONCLUSIONS: This case shows the feasibility of intraoperative fluorescence as a method to help identify subclinical PNI.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05945875.