68ga-dotanoc and Adenoma

Wermer/MEN1 syndrome is composed of the triad of pancreatic, pituitary, and parathyroid (3P's) tumors. We describe the Ga-DOTANOC PET/CT findings of a 43-year-old man, which revealed the classic 3P's of MEN1 syndrome with somatostatin receptor expression. The patient further underwent surgery for parathyroid lesions, which were suggestive of adenomas.

Topics: Adenoma; Adult; Gene Expression Regulation, Neoplastic; Humans; Male; Multiple Endocrine Neoplasia Type 1; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Receptors, Somatostatin

Tumor-induced osteomalacia is a rare paraneoplastic syndrome, usually caused by small benign mesenchymal tumors. The tumors most arise within the extremities, whereas occurrence within the parotid gland is quite rare. A 54-year-old woman who presented with bone pain and muscle weakness for 2 years was clinically suspected of having tumor-induced osteomalacia. A Ga-DOTANOC PET/CT was performed for localization of the causative tumor. The images demonstrated intense radiotracer accumulation in a soft tissue nodule in deep lobe of the right parotid gland. Subsequent surgical resection and pathologic analysis confirmed the diagnosis of parotid basal cell adenoma.

Topics: Adenoma; Female; Humans; Middle Aged; Neoplasms, Connective Tissue; Organometallic Compounds; Osteomalacia; Paraneoplastic Syndromes; Parotid Neoplasms; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals

Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors account for approximately 10% of Cushing's syndrome (CS). We present an extremely rare case of a patient with CS caused by an ectopic ACTH-secreting pituitary adenoma (EAPA) of the ethmoid sinus. The tumor was identified by positron-emission tomography-computed tomography (PET/CT) using the somatostatin receptor analogue Ga-68-DOTANOC. Transnasal endoscopic resection was performed and the patient showed significant clinical improvement with normalization of the endocrine pituitary axis. Immunostaining showed a somatostatin receptor 2 and 5-positive ACTH-producing adenoma. In patients with ectopic ACTH secretion, Ga-68-DOTANOC-PET/CT may play an important role in the localization of EAPA. Transnasal endoscopic resection is the therapy of choice.

Topics: ACTH Syndrome, Ectopic; ACTH-Secreting Pituitary Adenoma; Adenoma; Adrenocorticotropic Hormone; Diagnosis, Differential; Gallium Radioisotopes; Humans; Male; Middle Aged; Multimodal Imaging; Organometallic Compounds; Paranasal Sinus Neoplasms; Positron-Emission Tomography; Tomography, X-Ray Computed