title: Somatostatin receptor imaging-guided pasireotide therapy in medullary thyroid cancer with ectopic adrenocorticotropin production.
abstract: A 51-year-old man with a history of metastatic medullary thyroid cancer (MTC) presented with high adrenocorticotropin (ACTH) and urinary free cortisol levels. The diagnosis of ectopic ACTH production, a rare MTC complication, was established in this patient. PET/CT using the somatostatin analogue DOTA-(Tyr)-octreotate labeled with gallium (Ga-DOTATATE) was performed, showing positive radionuclide uptake in multiple MTC metastases. After this therapy with the novel somatostatin analogue, pasireotide was initiated after which urinary free cortisol and ACTH levels decreased. The present case thus illustrates a potential theranostic use of Ga-DOTATATE PET/CT in MTC.
authors.affiliation: From the *Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany; †Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; ‡Department of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany; and §Department of Endocrinology, RWTH Aachen University Hospital, Aachen, Germany.
authors.forename: Frederik A
authors.initials: FA
authors.lastname: Verburg
authors.forename: Martin
authors.initials: M
authors.lastname: Anlauf
authors.forename: Felix M
authors.initials: FM
authors.lastname: Mottaghy
authors.forename: Wolfram
authors.initials: W
authors.lastname: Karges
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D018278:Carcinoma, Neuroendocrine; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D013004:Somatostatin; D000324:Adrenocorticotropic Hormone; C517782:pasireotide; C513399:gallium Ga 68 dotatate