18F-FDG PET/CT rarely provides additional information other than primary tumor detection in patients with pulmonary carcinoid tumors

Tatci, Ebru; Özmen, Özlem; Gökçek, Atila; Biner, Inci Uslu; Özaydin, Esra; Kaya, Sadi; Arslan, Nuri

doi:10.4103/1817-1737.140134

Cited by 21 publications

(25 citation statements)

References 20 publications

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“…It is reported 18F-FDG PET-CT may be effective in early diagnosis of TPC, but this issue is controversial at present. [ 13 ] However, in our case, the ectopic source was located in middle lobe of right lung and it is quite difficult to distinguish with other pulmonary nodules on CT scan, such as intrapulmonary lymph nodes. The character of the nodule was defined by FDG PET-CT.…”

Section: Discussionmentioning

confidence: 66%

Cushing's syndrome secondary to typical pulmonary carcinoid with mutation in BCOR gene

Lan²,

Li³

et al. 2017

Medicine

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Rationale:Typical pulmonary carcinoid is a kind of low-grade malignancy neuroendocrine tumor. Cushing's syndrome is a very rare clinical feature of typical pulmonary carcinoid caused by hypercorticism. Complete tumor resection is the standard curative treatment for primary typical pulmonary carcinoid. However, our knowledge on the gene level of typical pulmonary carcinoid is limited.Patient concerns:A 42-year-old man was admitted to our hospital for progressive weight gain within one year. No other obvious symptoms were obsessed in this patient. He was clinical diagnosed with ectopic adrenocorticotropic hormone syndrome through hormonal tests and imaging exams. Positron emission tomography-computed tomography detected a pulmonary nodule localized in the middle lobe of the lung and it is thought to be the ectopic source.Intervention:This patient received a pulmonary wedge resection. After the surgery, a genetic sequencing was performed and it reported a mutation (S1240Cfs∗21) in the BCOR gene.Diagnosis:Postoperative pathology confirmed the diagnosis of ACTH-producing typical pulmonary carcinoid.Outcomes:The patient had a smooth postoperative course and no recurrence of the tumor was found for 3 years.Lessons:Mutation in BCOR gene is quite common in pulmonary neuroendocrine tumor and it has been proven to play a role in the development of some tumor. We herein first report BCOR gene mutation in Cushing's syndrome secondary to TPC and it may become a promising therapeutic target in the future.

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Section: Discussionmentioning

confidence: 66%

Cushing's syndrome secondary to typical pulmonary carcinoid with mutation in BCOR gene

Lan²,

Li³

et al. 2017

Medicine

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“…However, the studies by Erasmus et al and Krüger et al were limited by their size (7 and 13 patients, respectively) 13,15 . 18 F-FDG PET/CT is considered less well suited for imaging of neuroendocrine tumours with low proliferation rate, such as PCs 13,[20][21][22] . PCs are slow growing and their generally discrete 18 F-FDG uptake may lead to false-negative results.…”

Section: F-fdg Pet/ctmentioning

confidence: 99%

18F-FDG PET/CT Diagnosis of Bronchopulmonary Carcinoids Versus Pulmonary Hamartomas

Uhlén

Grundberg

Jacobsson

et al. 2016

Clinical Nuclear Medicine

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“…Some authors have reported that atypical carcinoids exhibited signi cantly higher FDG uptake than did typical carcinoids [16][17][18][19]. Tatci et al also observed a higher SUV max for atypical carcinoids than for typical carcinoids, although the difference was not statistically signi cant [20]. Fink et al analysed the clinicopathological data and outcomes of 142 patients with pulmonary carcinoids (128 typical and 14 atypical) and found that atypical carcinoids were associated with higher rates of nodal involvement and distant metastases [21].…”

Section: Discussionmentioning

confidence: 99%

Use of 18F-FDG PET/CT to differentiate ectopic adrenocorticotropic hormone-secreting lung tumours from tumour-like pulmonary infections in patients with ectopic Cushing syndrome

Hou

Jiang

et al. 2020

Preprint

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Purpose: Ectopic adrenocorticotropic hormone (ACTH)-secreting lung tumours represent the most common cause of ectopic Cushing syndrome (ECS). Pulmonary opportunistic infections are associated with ECS and occasionally difficult to differentiate from tumours by using computed tomography (CT) alone. The aim of the present study was to evaluate the usefulness of 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT (18F-FDG PET/CT) for differentiating ectopic ACTH-secreting lung tumours from tumour-like pulmonary infections in patients with ECS.Methods: We retrospectively reviewed the imaging data for 24 patients with ECS who were suspected to have ACTH-secreting lung tumours and underwent 18F-FDG PET/CT between 2008 and 2019.Results: In total, 18 patients had lung tumours (17 carcinoids and 1 small cell lung cancer) and six had pulmonary infections (cryptococcosis, n = 3; aspergillosis, n = 4; pulmonary abscess, n = 1). The primary source of ECS remained occult in the six patients with pulmonary infections. The maximum standardized uptake value (SUVmax) for pulmonary infections was significantly higher than that for tumours (P = 0.008). Receiver operating characteristic analysis was performed, and it was found that a cut-off SUVmax of 4.95 helped in differentiating lung tumours from infections with 75% sensitivity and 94.4% specificity. In subgroup analysis of 12 typical and five atypical carcinoids, there was no significant between-group difference with respect to SUVmax, the lesion size, the ACTH level, and the prevalence of regional lymph node metastasis.Conclusions: Our findings suggest that pulmonary infections exhibit significantly higher FDG uptake than do ACTH-secreting lung tumours in 18F-FDG PET/CT. Therefore, SUVmax (cut-off 4.95) may be useful for differentiating the two conditions. Typical and atypical ACTH-secreting lung carcinoids may show a similar clinical behaviour and appearance on 18F-FDG PET/CT.

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18F-FDG PET/CT rarely provides additional information other than primary tumor detection in patients with pulmonary carcinoid tumors

Cited by 21 publications

References 20 publications

Cushing's syndrome secondary to typical pulmonary carcinoid with mutation in BCOR gene

Cushing's syndrome secondary to typical pulmonary carcinoid with mutation in BCOR gene

18F-FDG PET/CT Diagnosis of Bronchopulmonary Carcinoids Versus Pulmonary Hamartomas

Use of 18F-FDG PET/CT to differentiate ectopic adrenocorticotropic hormone-secreting lung tumours from tumour-like pulmonary infections in patients with ectopic Cushing syndrome

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