Triple Tracer Positivity in Metastatic Lymph Nodes from Well-Differentiated Neuroendocrine Tumor in MEN-1 Syndrome

Kavanal, Anwin Joseph; Bhadada, Sanjay Kumar; Sood, Anil K.; Kaur, Gurjeet; Parwaiz, Amber; Gulati, Ajay; Dahiya, Divya; Mittal, Bhagwant Rai

doi:10.2967/jnmt.119.237339

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Finally, F-choline uptake in well-differentiated neuroendocrine tumors has been described in various contexts including isolated pulmonary nodule (46) and metastatic mediastinal and cervical lymph nodes from gastro-entero-pancreatic neuroendocrine tumor (47). Some limitations should be acknowledged in our study.…”

Section: Discussionmentioning

confidence: 86%

Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging

Roland¹,

Drouet²,

Boulahdour³

et al. 2021

Quant Imaging Med Surg

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Background: 18 F-fluorocholine positron emission tomography/computed tomography (F-choline PET/ CT) is considered a cornerstone in the staging and restaging of patients with prostate cancer (PCa). The aim of this study was to retrospectively assess unusual uptakes in patients who underwent a F-choline PET/CT for the initial staging or for the restaging of a relapsing PCa.Methods: Three hundred and sixty-eight PCa patients were staged or restaged using F-choline PET/CT.Unusual uptakes were defined as uptakes occurring outside the usual paths of diffusion of PCa or as uptake in bone with a clear morphological evidence of nonmetastatic lesion. Results:We found unusual uptakes in 47/368 patients (12.8%). Among them, 41/47 presented with benign F-choline uptake, usually within lymph nodes, due to inflammatory processes (22/47). Other benign processes were found in: thyroid (3/47), adrenal gland (3/47), brain (2/47), liver (1/47), bowel (3/47), frontal sinus (1/47), lungs (4/47), parotid gland (1/47) and bone (1/47). The six remaining patients presented with a second cancer, including lymphoma (1/47), non-small cell lung cancer (4/47) and neuroendocrine tumor (1/47).Conclusions: unusual uptakes on F-choline PET/CT are quite frequent and should be explored since they may correspond to non-PCa.

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Section: Discussionmentioning

confidence: 86%

Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging

Roland¹,

Drouet²,

Boulahdour³

et al. 2021

Quant Imaging Med Surg

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“…On a particular scale, the imaging exploration of parathyroid glands such as 99m-Technetium scintigraphy following the biological diagnosis of primary hyperparathyroidism might provide captures not only of the thyroid (and even myocardium) but also of the pancreas; thus, the incidental detection of a pancreatic neoplasia has been reported in localization studies before parathyroidectomy. In this particular instance, further MEN1 gene testing is required [ 105 , 106 ].…”

Section: Introductionmentioning

confidence: 99%

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance

Carsote,

Nistor,

Gheorghe

et al. 2024

IJMS

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We aimed to provide an in-depth analysis with respect to three turning points in pancreas involvement in primary hyperparathyroidism (PHP): hypercalcemia-induced pancreatitis (HCa-P), MEN1 (multiple endocrine neoplasia)-related neuroendocrine tumors (NETs), and insulin resistance (IR). This was a comprehensive review conducted via a PubMed search between January 2020 and January 2024. HCa-P (n = 9 studies, N = 1375) involved as a starting point parathyroid NETs (n = 7) or pancreatitis (n = 2, N = 167). Case report-focused analysis (N = 27) showed five cases of pregnancy PHP-HCa-P and three reports of parathyroid carcinoma (female/male ratio of 2/1, ages of 34 in women, men of 56). MEN1-NET studies (n = 7) included MEN1-related insulinomas (n = 2) or MEN1-associated PHP (n = 2) or analyses of genetic profile (n = 3), for a total of 877 MEN1 subjects. In MEN1 insulinomas (N = 77), the rate of associated PHP was 78%. Recurrence after parathyroidectomy (N = 585 with PHP) was higher after less-than-subtotal versus subtotal parathyroidectomy (68% versus 45%, p < 0.001); re-do surgery was 26% depending on surgery for pancreatic NETs (found in 82% of PHP patients). MEN1 pathogenic variants in exon 10 represented an independent risk factor for PHP recurrence. A single pediatric study in MEN1 (N = 80) revealed the following: a PHP rate of 80% and pancreatic NET rate of 35% and 35 underlying germline MEN1 pathogenic variants (and 3/35 of them were newly detected). The co-occurrence of genetic anomalies included the following: CDC73 gene variant, glucokinase regulatory protein gene pathogenic variant (c.151C>T, p.Arg51*), and CAH-X syndrome. IR/metabolic feature-focused analysis identified (n = 10, N = 1010) a heterogeneous spectrum: approximately one-third of adults might have had prediabetes, almost half displayed some level of IR as reflected by HOMA-IR > 2.6, and serum calcium was positively correlated with HOMA-IR. Vitamin D deficiency was associated with a higher rate of metabolic syndrome (n = 1). Normocalcemic and mildly symptomatic hyperparathyroidism (n = 6, N = 193) was associated with a higher fasting glucose and some improvement after parathyroidectomy. This multilayer pancreas/parathyroid analysis highlighted a complex panel of connections from pathogenic factors, including biochemical, molecular, genetic, and metabolic factors, to a clinical multidisciplinary panel.

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Triple Tracer Positivity in Metastatic Lymph Nodes from Well-Differentiated Neuroendocrine Tumor in MEN-1 Syndrome

Cited by 2 publications

References 9 publications

Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging

Unusual uptakes on 18F-fluorocholine positron emission tomography/computed tomography (PET/CT): a retrospective study of 368 prostate cancer patients referred for a biochemical recurrence or an initial staging

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance

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