open access

Vol 69, No 1 (2018)
Case report
Submitted: 2016-11-06
Accepted: 2017-01-09
Published online: 2017-12-21
Get Citation

Cerebellar metastasis of papillary thyroid carcinoma detected with somatostatin receptor scintigraphy

Rafał Czepczyński, Anna Wyszomirska, Maria Gryczyńska, Ewelina Szczepanek-Parulska, Marek Ruchała
·
Pubmed: 29319129
·
Endokrynol Pol 2018;69(1):24-27.

open access

Vol 69, No 1 (2018)
Case report
Submitted: 2016-11-06
Accepted: 2017-01-09
Published online: 2017-12-21

Abstract

Introduction: Distant metastases of papillary thyroid carcinoma (PTC) may lack the ability to concentrate radioiodine. In such cases, positive somatostatin receptor scintigraphy might be useful in demonstrating the expression of somatostatin receptors that are potential therapeutic targets. To date, only a few cerebellar metastases from PTC have been reported in the literature.

Patient findings: We present an 82-year-old female, in whom an asymptomatic cerebellar metastasis from PTC was diagnosed by means of Tc-99m-EDDA/HYNIC-TOC scintigraphy four years after the initial diagnosis. She was previously treated with total thyroidectomy and regional lymph node dissection, followed by three cycles of radioiodine therapy. Despite persistently elevated thyroglobulin, no specific radioiodine accumulation was found in the whole body post-treatment scan. Tc-99m-EDDA/HYNIC-TOC scintiscan revealed foci of increased tracer uptake in the lungs, cervical lymph nodes, and a single focus in the head. Thus, therapy with octreotide LAR was initiated. The patient died four months later due to disseminated PTC.

Summary: In this paper, a patient with asymptomatic previously unknown non-iodine avid cerebellar metastasis of PTC diagnosed by means of scintigraphy using somatostatin analogue Tc-99m-EDDA/HYNIC-TOC is reported.

Conclusions: Somatostatin receptor scintigraphy might be useful in the visualisation of non-iodine avid PTC metastases and demonstrat­ing the expression of somatostatin receptors that are potential therapeutic targets.

Abstract

Introduction: Distant metastases of papillary thyroid carcinoma (PTC) may lack the ability to concentrate radioiodine. In such cases, positive somatostatin receptor scintigraphy might be useful in demonstrating the expression of somatostatin receptors that are potential therapeutic targets. To date, only a few cerebellar metastases from PTC have been reported in the literature.

Patient findings: We present an 82-year-old female, in whom an asymptomatic cerebellar metastasis from PTC was diagnosed by means of Tc-99m-EDDA/HYNIC-TOC scintigraphy four years after the initial diagnosis. She was previously treated with total thyroidectomy and regional lymph node dissection, followed by three cycles of radioiodine therapy. Despite persistently elevated thyroglobulin, no specific radioiodine accumulation was found in the whole body post-treatment scan. Tc-99m-EDDA/HYNIC-TOC scintiscan revealed foci of increased tracer uptake in the lungs, cervical lymph nodes, and a single focus in the head. Thus, therapy with octreotide LAR was initiated. The patient died four months later due to disseminated PTC.

Summary: In this paper, a patient with asymptomatic previously unknown non-iodine avid cerebellar metastasis of PTC diagnosed by means of scintigraphy using somatostatin analogue Tc-99m-EDDA/HYNIC-TOC is reported.

Conclusions: Somatostatin receptor scintigraphy might be useful in the visualisation of non-iodine avid PTC metastases and demonstrat­ing the expression of somatostatin receptors that are potential therapeutic targets.

Get Citation

Keywords

differentiated thyroid carcinoma, papillary thyroid carcinoma, cerebellar metastases, somatostatin receptors, somatostatin receptor scintigraphy

About this article
Title

Cerebellar metastasis of papillary thyroid carcinoma detected with somatostatin receptor scintigraphy

Journal

Endokrynologia Polska

Issue

Vol 69, No 1 (2018)

Article type

Case report

Pages

24-27

Published online

2017-12-21

Page views

2585

Article views/downloads

1008

DOI

10.5603/EP.a2018.0009

Pubmed

29319129

Bibliographic record

Endokrynol Pol 2018;69(1):24-27.

Keywords

differentiated thyroid carcinoma
papillary thyroid carcinoma
cerebellar metastases
somatostatin receptors
somatostatin receptor scintigraphy

Authors

Rafał Czepczyński
Anna Wyszomirska
Maria Gryczyńska
Ewelina Szczepanek-Parulska
Marek Ruchała

References (23)
  1. Salvati M, Frati A, Rocchi G, et al. Single brain metastasis from thyroid cancer: report of twelve cases and review of the literature. J Neurooncol. 2001; 51(1): 33–40.
  2. Pazaitou-Panayiotou K, Kaprara A, Chrisoulidou A, et al. Cerebellar metastasis as first metastasis from papillary thyroid carcinoma. Endocr J. 2005; 52(6): 653–657.
  3. Al-Dhahri SF, Al-Amro AS, Al-Shakwer W, et al. Cerebellar mass as a primary presentation of papillary thyroid carcinoma: case report and literature review. Head Neck Oncol. 2009; 1: 23.
  4. Decristoforo C, Mather SJ, Cholewinski W, et al. 99m-TcEDDA/HYNIC-TOC: a new 99m-Tc-labelled radiopharmaceutical for imaging somatostatin receptor-positive tumors: first clinical result and intra-patient comparison with 111-In-labelled octreotide derivates. Eur J Nucl Med. 2000; 27: 1318–1325.
  5. Gabriel M, Decristoforo C, Donnemiller E, et al. An intrapatient comparison of 99m-Tc EDDA/HYNIC-TOC with 111-In-DTPA-octreotide for diagnosis of somatostatin receptor expressing tumors. J Nucl Med. 2003; 44(5): 708–716.
  6. Bangard M, Béhé M, Guhlke S, et al. Detection of somatostatin receptor-positive tumours using the new 99mTc-tricine-HYNIC-D-Phe1-Tyr3-octreotide: first results in patients and comparison with 111In-DTPA-D-Phe1-octreotide. Eur J Nucl Med. 2000; 27(6): 628–637.
  7. Gabriel M, Froehlich F, Decristoforo C, et al. 99mTc-EDDA/HYNIC-TOC and (18)F-FDG in thyroid cancer patients with negative (131)I whole-body scans. Eur J Nucl Med Mol Imaging. 2004; 31(3): 330–341.
  8. Schlumberger M, Pacini F. Thyroid tumors. Éditions Nucléon, Paris 2003.
  9. Chiu AC, Delpassand ES, Sherman SI. Prognosis and treatment of brain metastases in thyroid carcinoma. J Clin Endocrinol Metab. 1997; 82(11): 3637–3642.
  10. Misaki T, Iwata M, Kasagi K, et al. Brain metastasis from differentiated thyroid cancer in patients treated with radioiodine for bone and lung lesions. Ann Nucl Med. 2000; 14(2): 111–114.
  11. Cha ST, Jarrahy R, Mathiesen RA, et al. Cerebellopontine angle metastasis from papillary carcinoma of the thyroid: case report and literature review. Surg Neurol. 2000; 54(4): 320–326.
  12. Michie HR, O'Bryan-Tear CG, Marsh H, et al. Cerebral metastases from occult papillary carcinoma of the thyroid. Br J Surg. 1987; 74(7): 647.
  13. Ota T, Bando Y, Hirai M, et al. Papillary carcinoma of the thyroid with distant metastases to the cerebrum: a case report. Jpn J Clin Oncol. 2001; 31(3): 112–115.
  14. Pacak K, Sweeney DC, Wartofsky L, et al. Solitary cerebellar metastasis from papillary thyroid carcinoma: a case report. Thyroid. 1998; 8(4): 327–335.
  15. Jyothirmayi R, Edison J, Nayar PP, et al. Case report: brain metastases from papillary carcinoma thyroid. Br J Radiol. 1995; 68(811): 767–769.
  16. Lecumberri B, Alvarez-Escolá C, Martín-Vaquero P, et al. Solitary hemorrhagic cerebellar metastasis from occult papillary thyroid microcarcinoma. Thyroid. 2010; 20(5): 563–567.
  17. Xu YH, Song HJ, Qiu ZL, et al. Brain metastases with exceptional features from papillary thyroid carcinoma: report of three cases. Hell J Nucl Med. 2011; 14(1): 56–59.
  18. Giammarile F, Houzard C, Bournaud C, et al. Diagnostic management of suspected metastatic thyroid carcinoma: clinical value of octreotide scintigraphy in patients with negative high-dose radioiodine scans. Eur J Endocrinol. 2004; 150(3): 277–283.
  19. Stokkel MPM, Reigman HIE, Verkooijen RBT, et al. Indium-111-Octreotide scintigraphy in differentiated thyroid carcinoma metastases that do not respond to treatment with high-dose I-131. J Cancer Res Clin Oncol. 2003; 129(5): 287–294.
  20. Płachcińska A, Mikołajczak R, Maecke HR, et al. Clinical usefulness of 99mTc-EDDA/HYNIC-TOC scintigraphy in oncological diagnostics: a preliminary communication. Eur J Nucl Med Mol Imaging. 2003; 30(10): 1402–1406.
  21. Hubalewska-Dydejczyk A, Fröss-Baron K, Mikołajczak R, et al. 99mTc-EDDA/HYNIC-octreotate scintigraphy, an efficient method for the detection and staging of carcinoid tumours: results of 3 years' experience. Eur J Nucl Med Mol Imaging. 2006; 33(10): 1123–1133.
  22. Czepczyński R, Parisella MG, Kosowicz J, et al. Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2007; 34(10): 1635–1645.
  23. Barresi V, Alafaci C, Salpietro F, et al. Sstr2A immunohistochemical expression in human meningiomas: is there a correlation with the histological grade, proliferation or microvessel density? Oncol Rep. 2008; 20(3): 485–492.

Regulations

Important: This website uses cookies. 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 jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

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