PET/CT Detection of Epstein–Barr Virus–Positive Lacrimal Sac Carcinoma in Unknown Primary Cervical Nodal Metastasis
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.
Authors
- Tingting Long (ORCID: https://orcid.org/0009-0008-1745-3280)
- Shuo Hu (ORCID: https://orcid.org/0000-0003-0998-8943)
- Binhua Luo (ORCID: https://orcid.org/0000-0002-5391-3933)
- Hao Lü (ORCID: https://orcid.org/0009-0007-6094-458X)
Institutions
- Central South University (CN)
- National Clinical Research (US)
- Xiangya Hospital Central South University (CN)
Publication Details
- Journal
- Clinical Nuclear Medicine
- Published
- 2025-07-30
- DOI
- https://doi.org/10.1097/rlu.0000000000006079
- Primary Topic
- Salivary Gland Tumors Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00