Tumor Heterogeneity Detected by 68Ga DOTATOC and 18F-FDG PET/CTs in One Malignant Insulinoma With Involvement of the Portal Splenic Confluence and Ovarian Metastases.
A 67-year-old woman was referred for staging of an insulinoma. CT has shown a pancreatic tumor, a portal thrombus, and an ovarian mass presumed not to be related with the insulinoma. These three lesions were highly positive on Ga DOTATOC PET/CT, leading to the hypothesis of a malignant insulinoma with neoplastic vein thrombus and ovarian metastasis, which was subsequently confirmed histologically. Despite severe hypoglycemia preventing fasting, F-FDG PET/CT was informative, showing significant uptake by the thrombus, which corresponded to the most aggressive lesion (Ki67 of 3.5% for the primary pancreatic tumor and 19.6% for the thrombus).
From the *Department of Nuclear Medicine, Hôpital Tenon APHP and UPMC Sorbonne University, Paris; †Department of Nuclear Medicine, Hôpitaux Tenon and Saint Antoine APHP and UPMC Sorbonne University, Paris; and ‡Department of Endocrinology, Hôpital Saint Antoine APHP and UPMC Sorbonne University, Paris, France.
Ophélie
O
Bélissant Benesty
Thibaut
T
Cassou-Mounat
Camille
C
Vatier
Jean-Noël
JN
Talbot
Françoise
F
Montravers
D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology
C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D015282:Octreotide