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.
Meyerstein Institute of Oncology, and Department of Surgery, University College London Medical School, United Kingdom.
E M
EM
Prvulovich
R C
RC
Stein
J B
JB
Bomanji
J A
JA
Ledermann
I
I
Taylor
P J
PJ
Ell
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