68ga-dotanoc and Multiple-Endocrine-Neoplasia-Type-1

Multiple endocrine neoplasia 1 (MEN1) syndrome is an autosomal dominant syndrome comprising a triad of pancreatic, pituitary, and parathyroid tumors. Adrenal cortical carcinoma occurs rarely in MEN1 syndrome. Here, we have presented a case of a 62-year-old woman with adrenal mass and elevated serum parathormone levels, who underwent 68Ga-DOTANOC PET/CT. 68Ga-DOTANOC PET/CT showed intense tracer concentration in the left adrenal mass and lesions in the liver, pancreas, and peritoneum. Biopsy of the peritoneal deposit revealed metastatic adrenocortical carcinoma, and further genetic testing showed MEN1 mutation.

Topics: Adrenal Cortex Neoplasms; Adrenocortical Carcinoma; Female; Humans; Middle Aged; Multiple Endocrine Neoplasia; Multiple Endocrine Neoplasia Type 1; Organometallic Compounds; Positron Emission Tomography Computed Tomography

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

A patient multiple endocrine neoplasia type 1 presenting with radiological suspicion of pancreatic neuroendocrine tumor relapse after surgical and somatostatin analog treatment underwent restaging Ga-DOTANOC PET/CT. Standard and delayed images detected an area of focal intense uptake moving from the left para-aortic to the paracaval region. The lesion was identified at previous imaging in different abdominal locations (eg, adjacent to the duodenal wall at presurgical PET and in the aortocaval region at restaging contrast-enhanced CT). Dual time-point Ga-DOTANOC PET/CT was crucial to accurately diagnose the wandering mesenteric lymph node, a potential interpretation pitfall especially when found far from the initial position.

Topics: Aged; Delayed Diagnosis; Diagnosis, Differential; Female; Humans; Lymph Nodes; Mesentery; Multiple Endocrine Neoplasia Type 1; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals

Patients with multiple endocrine neoplasia type-1 syndromes are known to have neuroendocrine tumors (NETs) involving the pituitary and gastroenteropancreatic region, in addition to the presence of parathyroid abnormalities. In rare instances adenomas in the ectopic pituitary gland have been reported. As pituitary gland and pituitary adenomas are known to express SSTRs, somatostatin receptor scintigraphy can be used for imaging. Somatostatin receptor-based PET/CT imaging using 68Ga-DOTANOC has become a popular noninvasive imaging modality for evaluation of patients with NETs. The application of 68Ga-DOTANOC PET/CT can be extended to multiple endocrine neoplasia type 1 patients, as is evident from this case study.

Topics: Aged; Choristoma; Duodenal Diseases; Empty Sella Syndrome; Female; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Multiple Endocrine Neoplasia Type 1; Neuroendocrine Tumors; Organometallic Compounds; Pituitary Neoplasms; Positron-Emission Tomography; Tomography, X-Ray Computed