Should patients with anal canal SCC undergo an FNA biopsy of any palpable inguinal LN that is also FDG avid on PET/CT or should these nodes be assumed to be positive and treated to a higher dose?   

How do you manage a patient a with a PET positive inguinal lymph node who has a typical anal cancer? If a biopsy is done and it is negative, is it is safe to assume the lymph node is not involved even if it is clearly metabolically active? 



Answer from: Radiation Oncologist at Community Practice