ABSTRACT
La metayodobencilguanidina radiomarcada es un análogo de la norepinefrina que se utiliza en la localización de tumores que expresan transportadores de dicha neurohormona, especialmente los derivados de la cresta neural y de origen neuroendocrino, y en el tratamiento de sus metástasis cuando estas no son quirúrgicas. En la literatura revisada se encuentran mejorías sintomáticas, asociadas a un descenso de los niveles hormonales, en un porcentaje no despreciable de casos tras el tratamiento con 131I-MIBG. Sin embargo, la remisión tumoral completa se ha descrito en muy pocas ocasiones y casi nunca en presencia de metástasis óseas. Presentamos un caso de feocromocitoma maligno que tras el tratamiento con 131I-MIBG (600 mCi) alcanzó una respuesta hormonal y metabólica completa a pesar de la existencia de metástasis óseas (AU)
Radiolabeled metaiodobenzylguanidine is an analogue of norepinephrine used to localize tumors that express the neurohormone transporters, specifically those derived from the neural crest having a neuroendocrine origin. It is also used to treat non-surgical metastases derived from them. A review of the literature revealed symptomatic improvements associated to a decrease in hormone levels in a significant percentage of patients after 131I-MIBG treatment. However, complete tumor remission has been described only in very few cases and hardly ever when bone metastases exist. We present a case of a patient diagnosed of malignant pheochromocytoma who achieved complete hormonal and metabolic response after 131I-MIBG treatment (600 mCi) in spite of the presence of bone metastases (AU)
Subject(s)
Humans , Male , Adult , 3-Iodobenzylguanidine/therapeutic use , Pheochromocytoma/complications , Pheochromocytoma , Radionuclide Imaging/instrumentation , Radionuclide Imaging/methods , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Tomography, Emission-Computed/instrumentation , Tomography, Emission-Computed/methods , Tomography, Emission-Computed , Nuclear Medicine/methods , Nuclear Medicine/standardsABSTRACT
Radiolabeled metaiodobenzylguanidine is an analogue of norepinephrine used to localize tumors that express the neurohormone transporters, specifically those derived from the neural crest having a neuroendocrine origin. It is also used to treat non-surgical metastases derived from them. A review of the literature revealed symptomatic improvements associated to a decrease in hormone levels in a significant percentage of patients after (131)I-MIBG treatment. However, complete tumor remission has been described only in very few cases and hardly ever when bone metastases exist. We present a case of a patient diagnosed of malignant pheochromocytoma who achieved complete hormonal and metabolic response after (131)I-MIBG treatment (600 mCi) in spite of the presence of bone metastases.
Subject(s)
3-Iodobenzylguanidine/therapeutic use , Adrenal Gland Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Pheochromocytoma/drug therapy , Adrenal Gland Neoplasms/metabolism , Adrenal Gland Neoplasms/pathology , Bone Neoplasms/secondary , Humans , Male , Neurotransmitter Agents/biosynthesis , Pheochromocytoma/metabolism , Pheochromocytoma/secondary , Remission Induction , Young AdultABSTRACT
La esplenosis intratorácica es una entidad generalmente asintomática que se diagnostica de forma incidental tras la realización de una radiografía, TAC o RM por otro motivo. La realización de una gammagrafía con hematíes desnaturalizados marcados con 99mTc permite el diagnóstico no invasivo de esta entidad y evita técnicas de diagnóstico más agresivas. Dado que este tejido esplénico puede ser parcial o totalmente funcionante, y por tanto tener cierta función inmunológica beneficiosa para el paciente (suficiente para brindar protección frente a la sepsis postesplenectomía), el manejo de esta entidad debe ser conservador. La técnica radioisotópica de gammagrafía con hematíes desnaturalizados marcados con 99mTc es la que presenta mayor especificidad para la demostración de tejido esplénico. La presencia de nódulos pulmonares subpleurales, asociados o no a nódulos intraabdominales, junto con la existencia de antecedentes de esplenectomía parcial o total, traumática o no, deben hacer sospechar la presencia de una esplenosis intratorácica(AU)
Intrathoracic splenosis is a generally asymptomatic entity incidentally diagnosed after the completion of an Rx, CT scan or MRI for another reason. The performance of scintigraphy with 99mTc-labelled heat-denatured erythrocytes allows the noninvasive diagnosis of this entity and avoids more aggressive diagnostic techniques such as FNAP or thoracotomy. Because this splenic tissue may be partially or fully functioning and therefore may have some beneficial immune function for the patient, the management of this entity should be conservative. Radioisotopic scintigraphy with 99mTc labelled heat-denatured erythrocytes is the technique with the greatest specificity in the demonstration of splenic tissue. The presence of subpleural pulmonary nodules, associated or not with intra-abdominal nodules, together with the existence of previous partial or total splenectomy, traumatic or not, with or without associated rupture of the diaphragm, should raise suspicion of the presence of intrathoracic splenosis(AU)
Subject(s)
Humans , Male , Middle Aged , Splenosis/diagnosis , Technetium Tc 99m Exametazime , Splenosis/complications , Splenosis , Erythrocytes , Sensitivity and SpecificityABSTRACT
Intrathoracic splenosis is a generally asymptomatic entity incidentally diagnosed after the completion of an Rx, CT scan or MRI for another reason. The performance of scintigraphy with (99m)Tc-labelled heat-denatured erythrocytes allows the noninvasive diagnosis of this entity and avoids more aggressive diagnostic techniques such as FNAP or thoracotomy. Because this splenic tissue may be partially or fully functioning and therefore may have some beneficial immune function for the patient, the management of this entity should be conservative. Radioisotopic scintigraphy with (99m)Tc labelled heat-denatured erythrocytes is the technique with the greatest specificity in the demonstration of splenic tissue. The presence of subpleural pulmonary nodules, associated or not with intra-abdominal nodules, together with the existence of previous partial or total splenectomy, traumatic or not, with or without associated rupture of the diaphragm, should raise suspicion of the presence of intrathoracic splenosis.
Subject(s)
Diaphragm/injuries , Splenic Rupture/complications , Splenosis/diagnostic imaging , Thorax/diagnostic imaging , Accidents, Traffic , Aged , Asymptomatic Diseases , Erythrocytes , Humans , Incidental Findings , Male , Radionuclide Imaging , Rupture/complications , Splenosis/etiology , Technetium , Time FactorsABSTRACT
El cáncer diferenciado de tiroides es una enfermedad con muy buen pronóstico si se trata adecuadamente. El tratamiento ablativo con 131I frecuentemente se asocia al tratamiento quirúrgico en estos pacientes ya que mejora la supervivencia, y el rastreo corporal total con 131I es una de las modalidades de diagnóstico de elección en el seguimiento de esta enfermedad. Tras tratamiento ablativo del tejido tiroideo, cualquier depósito del radiotrazador en una localización no fisiológica representa habitualmente la presencia de metástasis. Así pues, será fundamental el reconocimiento de cualquier posible falso positivo con el fin de evitar la radiación innecesaria debida a tratamientos inadecuados. Presentamos un caso clínico de captación torácica por bronquiectasias que puede malinterpretarse como metástasis pulmonar(AU)
Differentiated thyroid cancer is a disease having a very good prognosis when treated adequately. Ablation treatment with 131I is frequently adjunct to surgery in these patients since it improves survival. Radioiodine whole-body scan is one of the imaging modality of choice in the follow-up of patients with this kind of pathology. After ablation treatment of the thyroid gland, any radioiodine accumulation in a non-physiological location usually means the presence of functioning metastasis. Recognition of potential false-positives is essential to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine. We report a case of uptake in the chest due to bronchiectasis, potentially masquerading as pulmonary metastasis(AU)
Subject(s)
Humans , Female , Middle Aged , 3-Iodobenzylguanidine , Iodine Radioisotopes , Thyroid Neoplasms , Carcinoma/complications , Carcinoma/diagnosis , Thyroglobulin/administration & dosage , Thyroglobulin , Bronchiectasis/complications , Bronchiectasis/diagnosis , Radiography, Thoracic , Thyroid Gland/pathology , Thyroid Gland , Carcinoma , Bronchiectasis , Goiter, Nodular/complications , Goiter, Nodular/surgeryABSTRACT
Differentiated thyroid cancer is a disease having a very good prognosis when treated adequately. Ablation treatment with (131)I is frequently adjunct to surgery in these patients since it improves survival. Radioiodine whole-body scan is one of the imaging modality of choice in the follow-up of patients with this kind of pathology. After ablation treatment of the thyroid gland, any radioiodine accumulation in a non-physiological location usually means the presence of functioning metastasis. Recognition of potential false-positives is essential to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine. We report a case of uptake in the chest due to bronchiectasis, potentially masquerading as pulmonary metastasis.
