Successful application of technetium-99m-labeled octreotide acetate scintigraphy in the detection of ectopic adrenocorticotropin-producing bronchial carcinoid lung tumor: a case report

Abstract

IntroductionThe diagnostic efficacy of somatostatin receptor scintigraphy labeling with 111 indium in the localization of tumors has been assessed in a limited number of patients with contradictory outcomes. Here, we describe the case of a patient with an ectopic adrenocorticotropic hormone-producing bronchial carcinoid tumor diagnosed preoperatively using technetium-99m-labeled octreotide acetate scintigraphy.Case presentationA 29-year-old Asian man presented to our hospital with the typical clinical features of Cushing's syndrome, which he had had for a duration of 18 months. The results of a biochemical evaluation revealed he had adrenocorticotropic hormone-dependent Cushing's syndrome. The results of a spiral abdominal computed tomography scan showed he had bilateral adrenal hypertrophy. A magnetic resonance image of the patient's brain showed he had a normal hypophysis. Whole body technetium-99m-labeled octreotide acetate scintigraphy was performed to check for the presence of an ectopic adrenocorticotropic hormone-producing tumor. The scan results showed a small focal increase in uptake in the lower lobe of our patient's right lung, just above his diaphragm. A spiral chest computed tomography scan also revealed a small non-specific lesion in the same region. A transthoracic biopsy was then performed. Pathological evaluation confirmed the diagnosis of a carcinoid tumor, of the adrenocorticotropic hormone-producing type. After surgical removal, the patient's symptoms resolved and significant clinical improvement was achieved.ConclusionsThis case report shows that technetium-99m-labeled octreotide acetate scintigraphy can effectively detect an ectopic adrenocorticotropic hormone-producing bronchial carcinoid.

Atypical or typical adrenocorticotropic hormone-producing pulmonary carcinoids and the usefulness of 11C-5-hydroxytryptophan positron emission tomography: two case reports

“…The usefulness of Tc-99m-SRS has been described in selected cases with success [7] and may have advantages over 111 In-pentetreotide-SRS used in our patient, with lower radiation dose and lower costs [6]. However, the tumor was not detected in our first patient and this could be due to possible lack of somatostatin receptors in the tumor or the size being only 8mm, which is near the resolution limit of 6mm for SRS methods [6].…”

“…In cases with a small cell carcinoma in the lung the radiological visualization of a tumor mass is in general obvious, whereas in ACTH-producing pulmonary carcinoids localization of the tumor could be unsuccessful using modalities like computed tomography (CT) and magnetic resonance imaging (MRI) of the patient's chest and abdomen [5]. Other techniques used to detect ectopic ACTH-secreting tumors with various results are somatostatin receptor scintigraphy (SRS) using 111 indium-pentetreotide ( 111 In-pentetreotide-SRS) [6] or technetium-99m-labeled octreotide acetate (Tc-99m-SRS) [7]. Pacak et al .…”

Two Cases With Cushing Syndrome: What an Anesthesiologist Should Know

“…There are reports in literature on the concurrent CS and pheochromocytoma [3,4], sarcoidosis [5], pancreatic acinar cell carcinoma [6], pre-eclamptic findings [7], malignant gastrinoma [8], bronchial carcinoid lung tumor [9], pancreatic neuroendocrine tumor [10], Hippel-Lindau disease [10], or mesenteric neuroendocrine carcinoma [11]. Our patients had nothing of these associations.…”

99mTc-Octreotide Uptake in the Uterus and a Subserosal Myoma Mimicking Tumoral Masses

“…Somat ostatin receptor scintigraphy is the functional technique used to assess neuroendocrine tumors (1). The diagnostic usefulness of somatostatin receptor scintigraphy in the localization of tumors has been evaluated in several studies (1).…”

“…The diagnostic usefulness of somatostatin receptor scintigraphy in the localization of tumors has been evaluated in several studies (1). Uptake on somatostatin receptor scintigraphy has also been observed in various cell elements such as lymphocytes, fibroblasts, and endothelium (1).…”