A pitfall with the use of 111In-pentetreotide scintigraphy in the resected bronchopulmonary carcinoids follow-up: a case report.

Abstract

AIM:

To re-evaluate the use of 111In-pentetreotide scintigraphy (Octreoscan) in the follow-up of patients operated for carcinoids, as second-step investigation, after chest X-ray, CT-scan and serological marker' levels.

METHODS AND RESULTS:

We describe the case of a female patient, 58-year-old, operated on for a non-secretory lung carcinoid. Five years after surgery, the CT-scan showed the enlargement of the bilateral hylo-mediastinal lymph nodes, suggestive for carcinoid recurrences. In order to confirm that, the patient was submitted to an Octreoscan that showed the presence of enlarged hylo-mediastinal adenopathies matching with the lesions observed at the CT-scan. Because the serological examination of NSE, chromogranin and serotonin, and the 5-HIIA were in the normal range, the patient was submitted to a lymph node biopsy through a mediastinoscopy. The histological examination of the specimens revealed a sarcoidosis and the patient was started on steroid therapy with good outcome.

CONCLUSIONS:

We conclude that: 1. the octreoscan scintigraphy in the follow-up of resected carcinoids can give false-positive results and 2. in consequence, the mediastinoscopy is a discriminating investigation in case of mediastinal lymph nodes disease.

• Authors: M Grazia, L Ansaloni, A Bini, G Grani, M Mastrorilli, D Pagani, F Sellitri, F Stella, R Bazzocchi
• Journal: Acta chirurgica Hungarica (Acta Chir Hung) Vol. 38 Issue 1 Pg. 35-7 ( 1999) ISSN: 0231-4614 [Print] Hungary
• PMID: 10439092 (Publication Type: Case Reports, Journal Article)

Chemical References

• Indium Radioisotopes
• Somatostatin
• pentetreotide

Topics

• Carcinoid Tumor (diagnostic imaging, surgery)
• False Positive Reactions
• Female
• Humans
• Indium Radioisotopes
• Lung Neoplasms (diagnostic imaging, surgery)
• Lymph Nodes (diagnostic imaging)
• Middle Aged
• Somatostatin (analogs & derivatives)
• Tomography, Emission-Computed, Single-Photon