PET Scan Results: Navigating Tumor Concerns and Symptoms - Oncology

Positron Emission Tomography (PET) Report Issues

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Hello Doctor, I sincerely ask for your help in analyzing my situation and providing some advice, as I feel very helpless and do not know how to handle this.
I am grateful for your assistance.
I have been experiencing a persistent foreign body sensation and sharp pain in my throat, from the uvula down to the left base of my tongue and deep throat.
Even when my mouth is closed, I still have symptoms and inflammation with a pulsating sensation.
Swallowing food feels like something is stuck, and swallowing saliva also causes discomfort.
Eating is not difficult, but there is a slight sharp pain.

I underwent a bilateral tonsillectomy and uvulopalatoplasty in April, and I am unsure if the pain and foreign body sensation are postoperative sequelae.
During a follow-up visit in July, the surgeon said my surgical site was fine.
However, my symptoms have persisted 24/7, with sudden sharp pains in my throat and a constant ringing in my left ear, along with occasional ear pain.
Over the past six months, I have undergone numerous examinations: nasopharyngoscopy in May, thyroid ultrasound in June, another nasopharyngoscopy in June, gastroscopy in July and September, another thyroid ultrasound in September, and a final nasopharyngoscopy in September.
An MRI of the head and neck in August with contrast showed specific lymphadenopathy on the right side of my neck, but no other significant issues were found.

The sensation of a foreign body and sharp pain in my throat has been constant, even when not eating or speaking, accompanied by a persistent inflammatory throbbing pain.
I also experience unilateral tinnitus and ear pain.
Due to my concerns about potential undetected issues, I underwent a PET scan at the end of September.
The report indicated a possible lesion in the area of the base of the tongue and epiglottis, but the doctor could not confirm the presence of cancer cells, suggesting it might be physiological changes but could not rule out the possibility of malignancy.

I found some information online regarding the SUV values, and the report indicated an SUVmax of 4.9, which raises concerns since values above 2.5 are more likely to indicate cancer.
I am very frightened and worried.
If there is a problem, I hope to address it as soon as possible to increase my chances of survival, especially since I have a three-year-old child at home.
I am truly scared and helpless.

I have attached the report and hope you can provide some advice on what I should do next.
Thank you.
I previously visited an ENT specialist at a health check hospital, but the doctor reviewed my report and said it was physiological changes and that I would not have any issues.
However, my symptoms persist, and the sensation of a foreign body and sharp pain is unbearable.
I consulted another hospital, and the doctor noted that my epiglottis appeared bright, suggesting that if confirmation is needed, a complete excision would be necessary, which is a major surgery.
Alternatively, they could take a biopsy from the brightest area, but there is no guarantee that the unbiopsied areas are free of issues.

I genuinely do not know how to ascertain whether there is a pathological change or cancer cells, or if my symptoms can be treated.
My symptoms cause me significant anxiety and discomfort, and I feel lost.
I sought a second opinion from a well-known ENT specialist at National Taiwan University.
Before seeing the main doctor, another doctor conducted a brief examination.
However, the main doctor quickly concluded that I had nasopharyngitis and advised me to buy a nasal spray without addressing my concerns in detail, which left me feeling disappointed.
Perhaps the doctor had too many patients and did not perceive my case as cancerous.

If my symptoms were not so prolonged and distressing, I could ignore them, but they have persisted for six months, and I am in constant discomfort.
It feels as if there is a bone lodged in my throat.
If I were to hypothetically have cancer, would it be nasopharyngeal cancer, or oropharyngeal cancer, or laryngeal cancer? Based on my symptoms, would it be considered early-stage? Would surgery be the first line of treatment, or are there other options? Having previously undergone a bilateral tonsillectomy, the postoperative pain was quite challenging, and I am very afraid of undergoing another oral surgery.

Currently, there are no obvious signs of disease from the endoscopic examination, and the doctor only mentioned that the lymph nodes are enlarged.
Would arranging for a narrow-band imaging (NBI) endoscopy be helpful? Would a biopsy of the suspected lesion in the epiglottis provide diagnostic clarity? Should I continue seeing an ENT specialist or consult an oncologist? I am currently taking medication for acid reflux and esophagitis, as well as medication for post-nasal drip and a nasal anti-inflammatory spray, but none of these have provided any relief or improvement.

I seek your help, thank you.

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Miss Lin, 40~49 year old female. Ask Date: 2021/11/08