Sampathirao N, Basu S. Rare Occurrence of Hypergastrinemia Due to
Thoracic Neuroendocrine Tumor: Detection and Characterization by 68Ga-DOTATATE PET/CT.
J Nucl Med Technol 2016;
44:203-4. [PMID:
26848167 DOI:
10.2967/jnmt.115.171603]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 01/22/2016] [Indexed: 11/16/2022] Open
Abstract
Hypergastrinemia is a prominent feature of a segment of gastroenteropancreatic neuroendocrine tumors, the gastrinomas, occurring mostly in the gastrinoma triangle. Hypergastrinemia due to a thoracic neuroendocrine tumor is a very rare occurrence, with a paucity of literature elucidating the same. We report a case of thoracic neuroendocrine tumor in a patient who had initially presented with symptoms of peptic ulcer disease of 3-y duration. On evaluation, the patient's fasting serum gastrin levels were found to be raised. Conventional imaging modalities and endoscopic evaluation did not identify the location of a possible gastrinoma or any other mass in the abdomen. In view of the hypergastrinemia, somatostatin receptor-targeted imaging with (68)Ga-DOTATATE PET/CT was undertaken and showed a somatostatin receptor-expressing paravertebral mass next to the thoracic aorta in the left lung. The mass was excised and was histopathologically suggestive of metastatic neuroendocrine tumor (MIB-1 labeling index, 2%). The present case underscores the importance of (68)Ga-DOTATATE PET/CT in both detecting and characterizing a causative lesion missed on contrast-enhanced CT, especially when the lesion is not easily amenable to biopsy.
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