Detection of Metastatic Adrenal Carcinoma Using¹³¹I-6-β-Iodomethyl-19-Norcholesterol Total Body Scans

Abstract

Adrenal and total body scintigraphs with 131I-6-beta-iodomethyl-19-norcholesterol were obtained in 5 patients who had had prior resection of adrenal cortical carcinoma. The results were compared with roentgenographic findings and liver, bone, and total body gallium-67 citrate scintigraphs. Metastatic lesions were detected with radiolabeled cholesterol in 4 of 5 patients, including 3 liver metastases, 2 bone metastases, and 1 lung metastasis. These lesions were also demonstrated by one or more of the other diagnostic modalities. All initial findings were negative in a fifth patient, who developed brain metastases within two months. The 6-methyl-analog of iodocholesterol makes it possible to detect metastatic adrenocortical carcinoma with total body scans. Whether or not this agent is "tumor specific" and will be of significant clinical utility will have to be determined more fully in a larger series of patients.

Outcome of brain metastases from adrenocortical carcinoma: a pooled analysis

“…Data on the disease outcome were available in seventeen adult patients. Among them, three patients died of systemic disease [ 21 , 25 , 26 ] in the absence of intracranial recurrence after local treatment on the brain (surgery alone or surgery followed by radiotherapy); two patients attained the intracranial “no evidence of disease” status (NED) and continued chemotherapy to achieve a systemic control of the disease [ 26 ]; twelve patients reported encephalic disease progression [ 19 , 20 , 22 – 24 , 26 ]. Thirteen adult patients died (13/17, 77%).…”

A rare bone–leptomeningeal metastasis from an adrenal cortical carcinoma

“…16,17 Intracranial metastasis associated with ACC is rare; only 9 patients who have this combination have been described. [5][6][7][8][9][10][11][12][13] Therefore, little is known regarding the biological behaviour of intracranial metastases from ACC and the best possible clinical approach to management of these lesions.…”

“…To our knowledge, there are nine reports of intracranial metastases arising from ACC (Table 1). [5][6][7][8][9][10][11][12][13] We report a patient, the second to our knowledge, who had skull and leptomeningeal metastasis from ACC.…”

Clinical experience with the adrenal scanning agents iodine 131-19-iodocholesterol and selenium 75-6-selenomethylcholesterol

“…The measurement of the radiocholesterol concentration in the surgical specimens has been reported only for iodocholesterols (Seabold et al 1976(Seabold et al , 1977Sarkar et al 1977;Nomura et al 1990). Selenocholesterol measurements are novel.…”