Neuroendocrine tumors (NETs) are rare in childhood.
Neuroblastoma is the most common pediatric extracranial solid
tumor, occurring >90% in children younger than 5 years of age.
Pheochromocytoma and
paraganglioma are rare NETs, causing
hypertension in 0.5-2% of hypertensive children. Gastroenteropancreatic NETs can occur in children and are classified into
carcinoids and pancreatic
tumors. Nuclear medicine procedures have an essential role both in the diagnosis and treatment of NETs. Metaiodobenzylguanidine (
MIBG) labeled with radioiodine has a well-established role in diagnosis as well as therapeutic management of the
neuroblastoma group of diseases. During recent decades, establishing the abundant expression of
somatostatin receptors by NETs first led to scintigraphy with
somatostatin analogs (i.e. Tc/In-
octreotide) and, later, with the emergence of positron-emitting labeled agents (i.e. Ga-DOTATATE/
DOTATOC/DOTANOC) PET scans with significantly higher detection efficiency became available.
Therapy with
somatostatin analogs labeled with beta emitters such as Lu-177 and Y-90, known as
peptide receptor radionuclide therapy, is a promising new option in the management of patients with inoperable or metastasized NETs. In this article, pediatric NETs are briefly reviewed and the role of radioactive agents in the detection and treatment of these
tumors is discussed.