18F-DOPA PET/CT but not 68Ga-DOTA-TOC PET/CT revealed the underlying cause of ectopic Cushing syndrome.
F-DOPA PET/CT but not Ga-DOTA-TOC PET/CT revealed the cause of ectopic Cushing syndrome in a 61-year-old man. The patient presented with rapid weight gain, swollen legs, and sleep disturbances. Plasma potassium level was 2.7 mM (reference range, 3.3-4.9 mM), 24-hour urinary cortisol level was 13,124 nmol (reference range, 30-144 nmol), and plasma adrenocorticotropin level was 61 ng/L (reference range, <48 g/L). CT demonstrated prominent lymph nodes in the left lung hilus and hyperplastic adrenals but no primary tumor. Ga-DOTA-TOC PET/CT, which is recommended as the first-line PET imaging, was performed, but it was not diagnostic. Imaging with F-DOPA PET/CT revealed the underlying cause.
Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, PO Box 340, FI-00290 Helsinki, Finland. camilla.schalin-jantti@hus.fi
Camilla
C
Schalin-Jäntti
Aapo
A
Ahonen
Marko
M
Seppänen
D003480:Cushing Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine; D015282:Octreotide