A pitfall with the use of 111In-pentetreotide scintigraphy in the resected bronchopulmonary carcinoids follow-up: a case report.
OBJECTIVE
To re-evaluate the use of 111In-pentetreotide scintigraphy (Octreoscan) in the follow-up of patients operated for carcinoids, as second-step investigation, after chest X-ray, CT-scan and serological marker' levels.


RESULTS
We describe the case of a female patient, 58-year-old, operated on for a non-secretory lung carcinoid. Five years after surgery, the CT-scan showed the enlargement of the bilateral hylo-mediastinal lymph nodes, suggestive for carcinoid recurrences. In order to confirm that, the patient was submitted to an Octreoscan that showed the presence of enlarged hylo-mediastinal adenopathies matching with the lesions observed at the CT-scan. Because the serological examination of NSE, chromogranin and serotonin, and the 5-HIIA were in the normal range, the patient was submitted to a lymph node biopsy through a mediastinoscopy. The histological examination of the specimens revealed a sarcoidosis and the patient was started on steroid therapy with good outcome.


CONCLUSIONS
We conclude that: 1. the octreoscan scintigraphy in the follow-up of resected carcinoids can give false-positive results and 2. in consequence, the mediastinoscopy is a discriminating investigation in case of mediastinal lymph nodes disease.
Grazia
M
M
Department of Surgical and Anesthesiological Sciences, University of Bologna, Italy.
Ansaloni
L
L
Bini
A
A
Grani
G
G
Mastrorilli
M
M
Pagani
D
D
Sellitri
F
F
Stella
F
F
Bazzocchi
R
R
D002276:Carcinoid Tumor / Q000000981:diagnostic imaging* / Q000601:surgery; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008875:Middle Aged; D013004:Somatostatin / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon
D007205:Indium Radioisotopes; D013004:Somatostatin; C081788:pentetreotide