Obstructive Jaundice: An Unusual Presentation of Neuroendocrine Differentiation in Prostatic Adenocarcinoma

Sampath Santhosh; Godwin Jeeva; Ranjan Kumar Mohapatra

doi:10.4103/ijnm.IJNM_127_20

Obstructive Jaundice: An Unusual Presentation of Neuroendocrine Differentiation in Prostatic Adenocarcinoma

Indian J Nucl Med. 2021 Jan-Mar;36(1):92-94. doi: 10.4103/ijnm.IJNM_127_20. Epub 2021 Mar 4.

Authors

Sampath Santhosh¹, Godwin Jeeva¹, Ranjan Kumar Mohapatra²

Affiliations

¹ Division of PET/CT, Gemini Scans, Chennai, Tamil Nadu, India.
² Institute of Oncology, SRM Institute of Medical Sciences, Chennai, Tamil Nadu, India.

Abstract

An elderly male on androgen deprivation therapy for prostatic adenocarcinoma presented with obstructive jaundice. Since biopsy from the head of the pancreas showed neuroendocrine carcinoma (NEC), he was diagnosed with second primary pancreatic NEC. Ga-68 DOTANOC positron emission tomography/computed tomography (PET/CT) done subsequently showed enlarged mildly DOTANOC-avid retroperitoneal nodes infiltrating the pancreas. These nodes were found to be progression of prostate-specific membrane antigen (PSMA) nonavid retroperitoneal nodes visualized in his Ga-68 PSMA PET/CT performed at another institution before 4 months, when there was no lesion in the pancreas. This observation revised the diagnosis from second primary pancreatic NEC to progression of neuroendocrine differentiation in preexisting prostatic adenocarcinoma.

Keywords: Ga-68 DOTANOC; Ga-68 prostate-specific membrane antigen; jaundice; neuroendocrine differentiation; positron emission tomography/computed tomography; prostatic adenocarcinoma.