Octreotide uptake in intracranial metastasis of pancreatic ductal adenocarcinoma origin in a patient with a prolonged clinical course.
We describe a case with prolonged survival of 2 years in a female patient with pancreatic ductal adenocarcinoma who, at diagnosis, already had liver spread and eventually succumbed to brain metastases which scanned positive with [(111)In-DTPA] octreotide scintiscan (OctreoScan). Subsequently, the patient underwent a craniotomy for resection of the metastases, but her condition deteriorated. A chromogranin A stain was negative, showing that there was no neuroendocrinal component to the cerebral secondaries. In contrast, tumor labeling with a monoclonal antibody associated with a favorable prognosis in pancreatic neoplasms was positive. There is mounting evidence that somatostatin receptor status confers a relatively favorable prognosis in pancreatic adenocarcinoma, although OctreoScan-positive brain metastases have not been previously reported.
Marepaily
Rama
R
Department of Internal Medicine, Neurosurgery, Nuclear Medicine and Pathology, John D. Dingell VAMC and Wayne State University School of Medicine, Detroit, MI, USA.
Micheals
Dan
D
Sloan
Andrew
A
Hatfield
James
J
Adsay
Volkan
V
Joyrich
Richard
R
Ullah
Nadeem
N
Tobi
Martin
M
D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary*; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D015282:Octreotide / Q000493:pharmacokinetics* / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D011379:Prognosis; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin / Q000378:metabolism; D013004:Somatostatin / Q000378:metabolism / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D007205:Indium Radioisotopes; D017481:Receptors, Somatostatin; D013004:Somatostatin; D015282:Octreotide