Imaging of a parapharyngeal hemangiopericytoma. Radioimmunoscintigraphy (SPECT) with indium-111-labeled anti-cea antibody, and comparison to digital subtraction angiography, computed tomography, and immunohistochemistry

Abstract

A 27-year-old male patient with a parapharyngeal hemangiopericytoma was investigated radiologically with orthopantomography, computed tomography, and digital subtraction angiography before the operation. Because a malignancy was suspected, the patient was imaged with gamma camera using radiolabeled monoclonal anticarcinoembryonal antigen antibody including single photon emission computed tomography. The radioantibody accumulated strongly into the neoplasm. Tumor to background ratio was 2.2. Samples of the excised tumor were stained immunohistochemically for desmin, vimentin, muscle actin, cytokeratin, CEA (carcinoembryonic antigen), and factor VIII. They showed that the antibody uptake was of unspecific nature and not due to CEA expression in the tumor.

Radioimmunodetection of Head and Neck Cancer: A Review

“…The non-specific uptake of immunoglobulins is probably due to the presence of the IgG-receptor in some tumors, causing non-specific uptake of radiolabeled antibodies without the expression of target antigens (47). In paraganglioma and parapharyngeal hemangiopericytoma we have demonstrated highly specific radioimmunolocalization (48,49) without immunohistological evidence of antigen expression. However, we did not have the opportunity to use antibodies against anti-CEA antibody to immunohistologically localize the radioantibody in tumor specimens.…”

The Natural History of Parapharyngeal Solitary Fibrous Tumor/Hemangiopericytoma: A Case Report

“…Up to date, only 22 cases of SFT/HPC arising in this region were reported in English literature (summarized in Table 1). 6-27…”

Hemangiopericytoma of the Parapharyngeal Space

“…It is possible that magnetic resonance angiography may replace formal angiography in the future for many lesions 7 . Other specific imaging tests, such as radioimmunoscintigraphy with indium-111-labeled monoclonal anticarcinoembryonal antigen antibody, have been recommended 8 …”

“…7 Other specific imaging tests, such as radioimmunoscintigraphy with indium-111-labeled monoclonal anticarcinoembryonal antigen antibody, have been recommended. 8 According to Carrau et al, 4 the use of embolization in vascular tumors is controversial because it may produce a severe inflammatory reaction around the tumor (especially in paragangliomas). However, in our patient the embolization was performed 1 day before surgery, and it was very helpful in decreasing the size of the tumor, reducing the blood loss, and making the surgery safer.…”