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Localization of Adrenocorticotropic Hormone-Secreting Bronchial Carcinoid Tumor by Somatostatin-Receptor Scintigraphy
- Mordechai Weiss, MD;
- Alon Yellin, MD;
- Monica Husza'r, MD;
- Zemach Eisenstein, MD;
- Jacob Bar-Ziv, MD; and
- Yodphat Krausz, MD
- From the E. Wolfson Medical Center, Holon, Israel; Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Hadassah University Hospital, Jerusalem, Israel. Requests for Reprints: Mordechai Weiss, MD, The E. Wolfson Medical Center, P.O. Box 5, Holon 58100, Israel.
Most ectopic adrenocorticotropic hormone (ACTH)-secreting tumors are bronchial carcinoids [1], and many are malignant [2]. Intensive localization studies are therefore warranted. However, frequently, and especially in small centrally located tumors, various imaging modalities are inconclusive. Recently, somatostatin receptor scintigraphic studies using the radiolabeled long-acting somatostatin analog Indium-111-pentetreotide (Mallinckrodt Medical, Pettem, the Netherlands) have enabled the detection of medullary thyroid carcinoma and islet cell tumor, both secreting ACTH. However, a small ACTH-secreting bronchial carcinoid was not similarly identified [3]. We describe a patient with ACTH-producing malignant bronchial carcinoid in whom octreotide scintigraphy led to localization of the tumor and its successful resection.
Case Report
A 22-year-old woman presented with a 3-month history of postpartum amenorrhea. Physical examination showed a blood pressure of 190/100 mm Hg, moon facies, and truncal obesity. Prominent purple striae covered her abdominal and chest walls. No goiter was palpable. Laboratory data included serum cortisol concentrations of 966 nmol/L at 0800 h (normal, 138 to 552 nmol/L) …
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