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Case Reports
. 2020 Aug 22;19(4):417-420.
doi: 10.4103/wjnm.WJNM_16_20. eCollection 2020 Oct-Dec.

Somatostatin receptor molecular imaging in a misdiagnosed gastrinoma case

Cati Raluca Stolniceanu  1   2 , Irena Cristina Grierosu  1   2 , Milovan Matovic  3   4 , Cipriana Stefanescu  1   2
Affiliations
Case Reports

Somatostatin receptor molecular imaging in a misdiagnosed gastrinoma case

Cati Raluca Stolniceanu et al. World J Nucl Med. .

Abstract

Gastrin-secreting tumors, hypergastrinemia and severe ulcer disease form the trademarks of Zollinger-Ellison syndrome (ZES). We report a case of gastrinoma, in a patient who was misdiagnosed for almost five years. The case emphsizes the the special role of functional imaging in the personalized approach to the patient with suggestive symptomatology for NETs. Taking into account that in 80 to 100% of cases of gastroenteropancreatic (GEP) NETs are expressing somatostatin receptors, the functional imaging with radiolabeled somatostatin analogues can be used in order to improve its diagnosis, respectively the treatment of GEP NETs. In the approach to the patient with tremendous digestive symptomatology, physicians from different specialties should evaluate NETs specific markers and then insist on structural-functional complementarity, avoiding the waste of time and high cost of repeated structural investigations. The conclusion of our study is that functional imaging is mandatory in the diagnostic algorithm of gastrinoma.

Keywords: Functional imaging; gastrinoma; hypergastrinemia; neuroendocrine tumors; somatostatin receptor scintigraphy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The different imaging techniques in a 44-years-old male with a neuroendocrine tumor. Computed tomography scan of the thorax (a and c); 99mTc tektrotyde scintigraphy (b and d)
Figure 2
Figure 2
Heterogeneity graph. Evolution of uptake indices (I1 = Tumor/liver, I2 = Tumor/spleen, I3 = Tumor/lung, I4 = Tumor/right thigh): early, 2, 4 and 24 h
Figure 3
Figure 3
Intense uptake, Krenning scale Grade 4, limited tumor burden score, with possible pancreatic localization, confirming the presence of somatostatin receptors and advocating the presence of NET. Uptake indices early (a), at 2 h (b), 4 h (c), 24 h (d). A-Tumour ROI; B-Liver ROI; C-Spleen ROI; D-Lung-ROI; E- Right tight-ROI
See this image and copyright information in PMC

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