Diagnostic usefulness of FDG-PET for malignant somatostatinoma of the pancreas.
Diagnostic usefulness of FDG-PET for malignant somatostatinoma of the pancreas.
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发表时间：
2008-07
影响因子：
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通讯作者：
Hideki Suzuki;H. Kuwano;N. Masuda;S. Hashimoto;K. Kanoh;K. Nomoto;T. Shimura;H. Katoh
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文献类型：
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作者：
Hideki Suzuki;H. Kuwano;N. Masuda;S. Hashimoto;K. Kanoh;K. Nomoto;T. Shimura;H. Katoh
一名24岁女性主诉腹泻和背痛入院，计算机断层扫描（CT）显示胰头肿瘤。腹部超音波、电脑断层及腹腔血管造影显示胰脏有一个血管增生的病灶。怀疑是内分泌肿瘤，特别是生长抑素瘤，并检查了血液中的激素水平。血清激素水平正常，因此进行了FDG-PET。在FDG-PET图像上检测到胰腺头部异常高的FDG积聚，病变的SUV为3.2，因此FDG-PET上认为肿块是恶性的。术前诊断为恶性内分泌肿瘤，行保留幽门的胰腺切除术。切除的标本显示胰头有一个巨大的黄白色肿瘤，大小为50 x 45 x 38 mm。组织学上，肿瘤是一个恶性胰岛细胞瘤，免疫化学上，肿瘤被抗生长抑素抗体染色，但没有被胰高血糖素、胰岛素或血管活性肠多肽抗体染色。患者术后出院，5年来一直保持良好，无复发。然而，肝转移瘤在手术后6年出现。
A 24-year-old female complaining of diarrhea and back pain was admitted to hospital where a tumor of the pancreatic head was revealed on a computed tomography (CT) scan. Abdominal ultrasonography, CT and celiac angiography revealed a hypervascular lesion on the pancreas. An endocrine tumor, particularly a somatostatinoma, was suspected and hormone levels in the blood were examined. Serum hormone levels were normal, so FDG-PET was performed. An abnormally high accumulation of FDG was detected on the FDG-PET image at the head of the pancreas, and the SUV of the lesion was 3.2, so the mass was considered to be malignant on FDG-PET. Pylorus-preserving pancreatoduodenectomy was performed with a preoperative diagnosis of malignant endocrine tumor. The resected specimen revealed a massive, yellowish-white tumor of the pancreas head measuring 50x 45x38mm. Histologically, the tumor was a malignant islet-cell tumor, and immunohistochemically the tumor stained with an anti-somatostatin antibody, but not with antibodies against glucagons, insulin or vasoactive intestinal polypeptide. The patient was discharged after the operation and has remained well without recurrence for 5 years. Liver metastatic tumors, however, appeared 6 years after the operation.