Somatostatin receptor tumor imaging (Tc 99m P829) in pituitary adenoma.

Technetium 99m P829 (99mTc P829) is a somatostatin like structure labelled with Technetium-99m. Somatostatin receptor positive tumors such as pituitary tumors, neuroendocrine tumors, and lymphomas show positive scintigraphy. Eleven patients suspected of having a pituitary mass (12 studies) were studied with 99mTc P829. Three pituitary adenoma patients (4 studies) showed positive somatostatin receptor tumor imaging. Eight negative somatostatin receptor scintigraphy were one hypothyroid induced pituitary hyperplasia, one craniopharyngioma, one normal pituitary tissue with focal hyperplasia, one ACTH secreting pituitary tumor, one GH, PRL secreting pituitary tumor post transphenoidal partial tumor removal, and no surgery in 3 patients. Finally, somatostatin receptor imaging may be useful as a tumor localizing technique in addition to conventional CT and MRI imaging and identify patients who might potentially benefit from octreotide treatment. In addition, the development of peptide analogs coupling to beta-emitting radiopharmaceutical may lead to a situation in which diagnosis peptide receptor scintigraphy can be followed by radionuclide therapy.

Metastatic follicular carcinoma of thyroid to pericardium.

A 62 year-old man presented with massive pericardial effusion and a thyroid nodule. One thousand ml of serosanguinous pericardial effusion was tapped and the cytology consistent with metastatic papillary carcinoma. Total thyroidectomy was done. The pathological report of the thyroid gland was follicular carcinoma, poorly differentiated with capsular and vascular invasion. The patient received a treatment of 150 mci I-131 without complications. The total body scan after I-131 treatment showed only residual thyroid tissue. There was no demonstrable abnormal uptake in other parts of the body. No significant reaccumulation of pericardial fluid occurred. The diagnosis was follicular carcinoma of the thyroid with pericardial metastasis. The patient was discharged from the hospital with an improved clinical status.