Iodine-131-MIBG therapy of a patient with carcinoid liver metastases.
Iodine-13I-metaiodobenzylguanidine (MIBG) is highly concentrated by >60% of carcinoid metastases and thus provides a therapeutic opportunity.


METHODS
A symptomatic patient with carcinoid liver metastases, unresponsive to chemotherapy combined with interferon-alpha, was subsequently treated with 131I-MIBG.


RESULTS
Radionuclide therapy, which was without significant side effects, resulted in symptomatic improvement and reduced urinary 5-hydroxyindoleacetic acid levels. No new metastases were observed for 15 mo after 131I-MIBG therapy. Gross cystic change occurred in existing liver metastases, presumably as a result of ischemic necrosis. Surgical deroofing and aspiration of cysts led to regeneration of normal liver tissue.


CONCLUSIONS
Iodine-131-MIBG therapy can provide prolonged symptomatic relief and improved quality of life in patients with metastatic carcinoid disease unresponsive to other therapies. The antitumor effect of 131I-MIBG was accompanied by few side effects, suggesting that this therapy should be considered in symptomatic patients with an early stage of disease.
Prvulovich
E M
EM
Meyerstein Institute of Oncology, and Department of Surgery, University College London Medical School, United Kingdom.
Stein
R C
RC
Bomanji
J B
JB
Ledermann
J A
JA
Taylor
I
I
Ell
P J
PJ
D019797:3-Iodobenzylguanidine / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008875:Middle Aged
D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine