Misleading 68 GALLIUM-dotatate PET scan in a patient with a history of a phaeochromocytoma: Unsuspected uptake in papillary thyroid carcinoma metastases.

Published on Mar 23, 2021in Journal of Neuroendocrinology3.627
· DOI :10.1111/JNE.12964
Daniel Moffat1
Estimated H-index: 1
 (QMUL: Queen Mary University of London), Polly Richards4
Estimated H-index: 4
 (QMUL: Queen Mary University of London)+ 3 AuthorsAshley Grossman11
Estimated H-index: 11
 (Green Templeton College)
Source
Abstract
Scanning for somatostatin receptors using 68 Ga-dotatate positron emission tomography with co-registration with computed tomography or magnetic resonance imaging is now in widespread use for the identification of neuroendocrine tumours, phaeochromocytomas, and paragangliomas and their metastases. We present a case where a patient with a phaeochromocytoma showed uptake in her neck considered diagnostic of a head-and-neck paraganglioma, which was subsequently confirmed to be a metastatic papillary thyroid carcinoma. We alert clinicians to such falsely-identified tumours using this extensively used imaging technique.
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#2Binglu LiH-Index: 10
Last. Xiaodong HeH-Index: 4
view all 4 authors...
: The incidence of papillary thyroid microcarcinoma (PTMC) has increased dramatically in recent years. Compared with central lymph node metastases, lateral neck lymph node (LNLN) metastases in patients with PTMC were less studied. The aim of the present study is to analyze the predicting factors associated with LNLN metastases in patients with PTMC.A total of 3514 patients underwent thyroid surgery at our hospital from January 2017 to December 2017, and 936 patients with PTMC were selected and a...
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#1Sangwon HanH-Index: 12
#2Chong Hyun Suh (UOU: University of Ulsan)H-Index: 35
Last. Jong Jin LeeH-Index: 12
view all 5 authors...
: We performed a systematic review and metaanalysis of the performance of 68Ga-DOTA-conjugated somatostatin receptor-targeting peptide (68Ga-DOTA-SST) PET in the detection of pheochromocytomas and paragangliomas (PPGLs). Methods: PubMed and Embase were searched until May 8, 2018. We included studies that reported the detection rate of 68Ga-DOTA-SST PET in patients with PPGLs. Detection rates were pooled using a random-effects model. Subgroup analyses and metaregression were performed to explore ...
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Jan 1, 2019·Neuroendocrinology4.91
#1Ingrid Y F Mak (Royal Free Hospital)H-Index: 1
#2Aimee R. Hayes (Royal Free Hospital)H-Index: 4
Last. Ashley Grossman (Royal Free Hospital)H-Index: 11
view all 4 authors...
: At present there is no clinical guideline or standardised protocol for the treatment of metastatic or invasive phaeochromocytoma and paraganglioma (collectively known as PPGL) due to the rarity of the disease and the lack of prospective studies or extended national databases. Prognosis is mainly determined by genetic predisposition, tumour burden, rate of disease progression, and location of metastases. For patients with progressive or symptomatic disease that is not amenable to surgery, there...
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#1Emilia Sbardella (University of Oxford)H-Index: 27
#2Treena Cranston (University of Oxford)H-Index: 20
Last. Ashley B. Grossman (University of Oxford)H-Index: 129
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Purpose Several new gene mutations have been reported in recent years to be associated with a risk of familial pheochromocytoma. However, it is unclear as to whether extensive genetic testing is required in all patients.
Source
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#1Lisa Bodei (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 25
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view all 4 authors...
: 68Ga-DOTATATE PET/CT provides information on the location of somatostatin receptor-expressing tumors. Integrating this imaging data effectively in patient care requires the clinical history; the histopathology and biomarker information; and the grade, stage, and prior imaging results. Previous therapies and technical aspects of the study should be considered, given their ability to alter the interpretation of the images. This includes physiologic biodistribution of the radiotracer, as well as ...
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Last. Tobias Else (UM: University of Michigan)H-Index: 33
view all 207 authors...
We report a comprehensive molecular characterization of pheochromocytomas and paragangliomas (PCCs/PGLs), a rare tumor type. Multi-platform integration revealed that PCCs/PGLs are driven by diverse alterations affecting multiple genes and pathways. Pathogenic germline mutations occurred in eight PCC/PGL susceptibility genes. We identified CSDE1 as a somatically mutated driver gene, complementing four known drivers (HRAS, RET, EPAS1, and NF1). We also discovered fusion genes in PCCs/PGLs, involvi...
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#1Jonathan R. Strosberg (USF: University of South Florida)H-Index: 50
#2Ghassan El-Haddad (USF: University of South Florida)H-Index: 18
Last. Heather A. Jacene (Harvard University)H-Index: 27
view all 35 authors...
BackgroundPatients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 (177Lu)–Dotatate in patients with advanced, progressive, somatostatin-receptor–positive midgut neuroendocrine tumors. MethodsWe randomly assigned 229 patients who had well-differentiated, metastatic midgut neuroendocrine tumors to receive ...
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view all 5 authors...
Head and neck paragangliomas are rare vascular tumors of neural crest origin that arise from extra-adrenal paraganglia of the autonomic system. The nomenclature of these tumors has been confusing throughout the literature. Most are benign tumors and rarely display malignant features. A majority of paragangliomas are sporadic with 10–30% representing familial cases. Most present as an asymptomatic mass in the head or neck, and MRI with and without contrast is the best initial imaging modality. Su...
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#1Stephen A. Deppen (VUMC: Vanderbilt University Medical Center)H-Index: 19
#2Jeffrey D. Blume (Vandy: Vanderbilt University)H-Index: 33
Last. Ronald C. Walker (Nationwide Children's Hospital)H-Index: 1
view all 8 authors...
Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that (68)Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with (111)In-DTPA-octreotide and conventional imaging. We performed a systematic review of (68)Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval.Medline, EMBASE, Web of Scie...
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#1Tatjana Traub-Weidinger (Medical University of Vienna)H-Index: 19
#2Daniel Putzer (Innsbruck Medical University)H-Index: 20
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view all 8 authors...
Purpose Radiolabelled somatostatin (SST) analogues have proven useful in diagnosing tumours positive for SST receptor (SSTR). As different subtypes of SSTR are expressed on the tumour cell surface, the choice of appropriate therapeutic SST analogue is crucial. We evaluated the SSTR status of thyroid cancer patients who had signs of progressive disease comparing different SSTR ligands for PET imaging to evaluate possible further therapeutic options.
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12
Cited By1
Newest
Jun 19, 2021·Endocrine Reviews19.87
#1Svenja Nölting (LMU: Ludwig Maximilian University of Munich)H-Index: 15
#2Nicole Bechmann (TUD: Dresden University of Technology)H-Index: 14
Last. Karel Pacak (NIH: National Institutes of Health)H-Index: 111
view all 9 authors...
Pheochromocytomas/paragangliomas are characterized by a unique molecular landscape that allows their assignment to clusters depending on underlying genetic alterations. With around 30-35% of Caucasian patients (a lower percentage in the Chinese population) showing germline mutations in susceptibility genes, pheochromocytomas/paragangliomas have the highest rate of heritability among all tumors. A further 35-40% of Caucasian patients (a higher percentage in the Chinese population) are affected by...
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1
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