Radioguided hepatic resection with 18F-DOPA in a patient with metastatic medullary thyroid carcinoma
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018 Jul-Aug;37(4):244-249.
doi: 10.1016/j.remn.2017.12.003.
Epub 2018 May 10.
[Article in
English,
Spanish]
Affiliations
- 1 Department of Oncologic Surgery, National Cancer Institute, Ciudad de México , México. Electronic address: dr.javierlopgom@gmail.com.
- 2 Nuclear Medicine Department, National Cancer Institute, Ciudad de Mexico, México.
- 3 Department of Oncologic Surgery, National Cancer Institute, Ciudad de México , México.
- 4 Surgical Department of Gastrointestinal Tumors, National Cancer Institute, Ciudad de México, México.
Abstract
Introduction:
Medullary carcinoma accounts for 1-2% of all thyroid malignancies. 13-20% of patients present with distant metastasis, with 45% of the cases affecting the liver.
Clinical case:
A 50-year-old woman, diagnosed with medullary thyroid carcinoma, was treated with total thyroidectomy and a modified neck dissection in 1999. Two lymph node recurrences in the neck were treated with surgical resection; during surveillance, she developed elevated calcitonin levels, the recurrence site was identified with 18F-DOPA PET/CT in the liver. Metabolic activity was not associated with a visible lesion in CT, MRI nor ultrasound. Radioguided surgery with 18F-DOPA allowed an anatomic resection of segments IVb and V.
Discussion:
In patients with medullary carcinoma and elevated calcitonin during surveillance, 18F-DOPA PET/CT is an option to evaluate the site of recurrence. Radioguided resection was feasible in this patient, whose hepatic recurrence was not visible with any other imaging method.
Conclusion:
Radioguided hepatic resection with 18F-DOPA in metastatic medullary thyroid carcinoma is feasible when the recurrence site is not anatomically identified by any other imaging studies.
Keywords:
(18)F-DOPA; Carcinoma medular de tiroides; Cirugía radioguiada; Medullary thyroid carcinoma; Metastasectomy; Metastasectomía; Radioguided surgery.
Copyright © 2017. Publicado por Elsevier España, S.L.U.
MeSH terms
-
Biomarkers, Tumor / blood
-
Calcitonin / blood
-
Carcinoma, Medullary / blood
-
Carcinoma, Medullary / diagnostic imaging
-
Carcinoma, Medullary / secondary*
-
Carcinoma, Medullary / surgery
-
Carcinoma, Neuroendocrine / diagnostic imaging*
-
Carcinoma, Neuroendocrine / radiotherapy
-
Carcinoma, Neuroendocrine / surgery
-
Combined Modality Therapy
-
Dihydroxyphenylalanine / analogs & derivatives*
-
Dihydroxyphenylalanine / analysis
-
False Negative Reactions
-
Female
-
Fluorodeoxyglucose F18 / analysis*
-
Hepatectomy / methods*
-
Humans
-
Liver Neoplasms / diagnostic imaging
-
Liver Neoplasms / secondary*
-
Liver Neoplasms / surgery
-
Lymphatic Metastasis
-
Magnetic Resonance Imaging
-
Middle Aged
-
Neck Dissection
-
Positron Emission Tomography Computed Tomography*
-
Radiopharmaceuticals / analysis*
-
Surgery, Computer-Assisted / methods*
-
Thyroid Neoplasms / diagnostic imaging*
-
Thyroid Neoplasms / radiotherapy
-
Thyroid Neoplasms / surgery
-
Thyroidectomy
-
Ultrasonography
Substances
-
Biomarkers, Tumor
-
Radiopharmaceuticals
-
Fluorodeoxyglucose F18
-
fluorodopa F 18
-
Dihydroxyphenylalanine
-
Calcitonin
Supplementary concepts
-
Thyroid cancer, medullary