open access

Vol 67, No 1 (2016)
Case report
Published online: 2016-02-17
Submitted: 2014-08-13
Accepted: 2014-09-16
Get Citation

Medullary thyroid carcinoma — PET/CT imaging with 68Ga-labelled gastrin and somatostatin analogues

Jolanta Kunikowska, Katarzyna Ziemnicka, Dariusz Pawlak, Marek Ruchała, Anna Kolasa, Małgorzata Janicka-Jedyńska, Aldona Woźniak, Renata Mikołajczak, Leszek Królicki
DOI: 10.5603/EP.2016.0010
·
Endokrynologia Polska 2016;67(1):68-71.

open access

Vol 67, No 1 (2016)
Case report
Published online: 2016-02-17
Submitted: 2014-08-13
Accepted: 2014-09-16

Abstract

Case presentation: a 75-year-old man with a 10-year history of nodular goitre was referred for clinical evaluation. The ultrasound scan revealed enlarged thyroid right lobe almost fully filled with a heterogeneous nodule with numerous calcifications. Fine-needle aspiration biopsy suggested medullary thyroid carcinoma (MTC). Before the surgery the patient was referred to the nuclear medicine department and somatostatin receptor imaging (SRS; 68Ga-DOTATATE) with PET/CT was performed. The scan demonstrated an increased uptake within the right thyroid mass. Subsequent PET/CT with 68Ga-gastrin analogue (MG48) revealed the same indications as the SRS: an increased alveolar uptake in the right thyroid mass without the signs of lymph node metastases. The patient underwent total thyroidectomy and central lymph nodes dissection. Histopathology examination confirmed the presence of MTC with vascular invasion, but without lymph node metastases (pT3NoMx according to the 7th edition of the AJCC Cancer Staging Manual). Immunohistochemical staining revealed positive reaction to calcitonin and CD56, whereas the reaction to thyroglobulin remained negative. The Ki-67 was 1%. Staining for SSTR2 and CCK2 showed high cytoplasmic expression in both cases.

Knowledge of the presence of CCK2 receptor in MTC patients may be an important indication for the choice of diagnostic and therapeutic procedures. The presence of both the receptor types, cholecystokinin-2/gastrin and somatostatin, is possibly an interesting combination as far as the therapeutic target is concerned. (Endokrynol Pol 2016; 67 (1): 68–71)

Abstract

Case presentation: a 75-year-old man with a 10-year history of nodular goitre was referred for clinical evaluation. The ultrasound scan revealed enlarged thyroid right lobe almost fully filled with a heterogeneous nodule with numerous calcifications. Fine-needle aspiration biopsy suggested medullary thyroid carcinoma (MTC). Before the surgery the patient was referred to the nuclear medicine department and somatostatin receptor imaging (SRS; 68Ga-DOTATATE) with PET/CT was performed. The scan demonstrated an increased uptake within the right thyroid mass. Subsequent PET/CT with 68Ga-gastrin analogue (MG48) revealed the same indications as the SRS: an increased alveolar uptake in the right thyroid mass without the signs of lymph node metastases. The patient underwent total thyroidectomy and central lymph nodes dissection. Histopathology examination confirmed the presence of MTC with vascular invasion, but without lymph node metastases (pT3NoMx according to the 7th edition of the AJCC Cancer Staging Manual). Immunohistochemical staining revealed positive reaction to calcitonin and CD56, whereas the reaction to thyroglobulin remained negative. The Ki-67 was 1%. Staining for SSTR2 and CCK2 showed high cytoplasmic expression in both cases.

Knowledge of the presence of CCK2 receptor in MTC patients may be an important indication for the choice of diagnostic and therapeutic procedures. The presence of both the receptor types, cholecystokinin-2/gastrin and somatostatin, is possibly an interesting combination as far as the therapeutic target is concerned. (Endokrynol Pol 2016; 67 (1): 68–71)

Get Citation

Keywords

medullary thyroid carcinoma; CCK2 receptor; somatostatin receptor; 68Ga; PET/CT

About this article
Title

Medullary thyroid carcinoma — PET/CT imaging with 68Ga-labelled gastrin and somatostatin analogues

Journal

Endokrynologia Polska

Issue

Vol 67, No 1 (2016)

Pages

68-71

Published online

2016-02-17

DOI

10.5603/EP.2016.0010

Bibliographic record

Endokrynologia Polska 2016;67(1):68-71.

Keywords

medullary thyroid carcinoma
CCK2 receptor
somatostatin receptor
68Ga
PET/CT

Authors

Jolanta Kunikowska
Katarzyna Ziemnicka
Dariusz Pawlak
Marek Ruchała
Anna Kolasa
Małgorzata Janicka-Jedyńska
Aldona Woźniak
Renata Mikołajczak
Leszek Królicki

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl