Abstract
Utility of111In-octreotide for the Characterization of an Extra-axial Lesion with uptake of 18F-choline PET-CT in a Patient with Adenocarcinoma of the Prostate
Highlights
We present a patient with prostate adenocarcinoma in whose evolution presented a biochemical relapse and the finding of 18F-choline uptake in an extra-axial brain lesion located in clivus with no conclusive Magnetic Resonance Imaging (MRI) for metastases
Given the findings of 18F-choline Positron Emission Tomography (PET)-Computed Tomography (CT), brain MRI and confirmed biochemical progression resistant to castration, the case was evaluated in the Neuro-Oncology Tumors Committee of our center, which decided to perform a SPECT-CT with 111In-octreotide to be able to clarify the differential diagnosis between a brain metastasis or meningioma in this location
The high ratio between phosphocholine and glycerophosphocholine is responsible for cellular transformation and cell immortalization and, in addition, this ratio is higher in atypical meningiomas [8]
Summary
Meningiomas account approximately 20% of primary brain tumors and nearly 1-2% are incidentally postmortem findings. In the context of a biochemical relapse in prostate adenocarcinoma and a single 18F-choline uptake in the brain, the differential diagnosis between a meningioma and a possible brain metastasis may be difficult. Numerous publications have reported overexpression of somatostatin receptors in meningiomas and the usefulness of 111In-octreotide in the non-invasive differential diagnosis of this type of lesions [7]. There are no conclusive data in the literature about an uptake of 111In-octreotide in brain metastases, except for tumors of neuroendocrine strain or with somatostatin receptors overexpression. We present a patient with prostate adenocarcinoma in whose evolution presented a biochemical relapse and the finding of 18F-choline uptake in an extra-axial brain lesion located in clivus with no conclusive MRI for metastases. Our findings highlight the relevance and clinical implication derived from the performance of a cerebral SPECT-CT with 111In-octreotide to the lesion characterization
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