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 wi...

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Bibliographic Details
Published inClinical nuclear medicine Vol. 41; no. 11; p. 874
Main Authors Bélissant Benesty, Ophélie, Cassou-Mounat, Thibaut, Vatier, Camille, Talbot, Jean-Noël, Montravers, Françoise
Format Journal Article
LanguageEnglish
Published United States 01.11.2016
Subjects
Aged
Female
Fluorodeoxyglucose F18
Humans
Insulinoma - diagnostic imaging
Insulinoma - pathology
Octreotide - analogs & derivatives
Organometallic Compounds
Ovarian Neoplasms - diagnostic imaging
Ovarian Neoplasms - secondary
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - pathology
Portal Vein - diagnostic imaging
Portal Vein - pathology
Positron Emission Tomography Computed Tomography
Radiopharmaceuticals
Spleen - diagnostic imaging
Spleen - pathology
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Summary: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).
ISSN:1536-0229
DOI:10.1097/RLU.0000000000001360