Abstract
A 71-year-old woman with type 2 diabetes mellitus complained of generalized fatigue. A 36-mm tumor in the pancreatic tail was detected with ultrasonography. The tumor was found to have marked hypervascularity with contrast-enhanced computed tomography (CT) and magnetic resonance. Combined 18F-fluorodeoxyglucose positron emission tomography and CT (18F-FDG PET/CT) showed 18F-FDG by the tumor with a maximal standardized uptake value of 2.98 at 50 min and 3.29 at 100 min following injection of 18F-FDG. 18F-FDG PET/CT suggested no extrapancreatic spread of the tumor. The patient had no pancreatic hormone-associated symptoms. Distal pancreatectomy was performed, and a well-differentiated endocrine tumor was diagnosed. The resected specimen showed neither infiltration of adjacent structures nor metastasis to regional lymph nodes. The present case suggests that 18F-FDG PET/CT is a reliable modality for staging endocrine pancreatic tumors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Oberg K, Eriksson B. Endocrine tumours of the pancreas. Best Pract Res Clin Gastroenterol 2005;19:753–781.
Inokuma T, Tamaki N, Torizuka T, Magata Y, Fujii M, Yonekura Y, et al. Evaluation of pancreatic tumors with positron emission tomography and F-18 fluorodeoxyglucose: comparison with CT and US. Radiology 1995;195:345–352.
Nakamoto Y, Higashi T, Sakahara H, Tamaki N, Itoh K, Imamura M, et al. Evaluation of pancreatic islet cell tumors by fluorine-18 fluorodeoxyglucose positron emission tomography: comparison with other modalities. Clin Nucl Med 2000;25:115–119.
Adams S, Baum R, Rink T, Schumm-Drager PM, Usadel KH, Hor G. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med 1998;25:79–83.
von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology 2006;238:405–422.
Endo K, Oriuchi N, Higuchi T, Iida Y, Hanaoka H, Miyakubo M, et al. PET and PET/CT using 18F-FDG in the diagnosis and management of cancer patients. Int J Clin Oncol 2006;11:286–296.
Procacci C, Carbognin G, Accordini S, Biasiutti C, Bicego E, Romano L, et al. Nonfunctioning endocrine tumors of the pancreas: possibilities of spiral CT characterization. Eur Radiol 2001;11:1175–1183.
Rodallec M, Vilgrain V, Zins M, Couvelard A, Ruszniewski P, Menu Y. Helical CT of pancreatic endocrine tumors. J Comput Assist Tomogr 2002;26:728–733.
Noone TC, Hosey J, Firat Z, Semelka RC. Imaging and localization of islet-cell tumours of the pancreas on CT and MRI. Best Pract Res Clin Endocrinol Metab 2005;19:195–211.
Herwick S, Miller FH, Keppke AL. MRI of islet cell tumors of the pancreas. AJR Am J Roentgenol 2006;187:W472–480.
Rosch T, Lightdale CJ, Botet JF, Boyce GA, Sivak MV Jr, Yasuda K, et al. Localization of pancreatic endocrine tumors by endoscopic ultrasonography. N Engl J Med 1992;326:1721–1726.
Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]-and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716–731.
Lebtahi R, Cadiot G, Sarda L, Daou D, Faraggi M, Petegnief Y, et al. Clinical impact of somatostatin receptor scintigraphy in the management of patients with neuroendocrine gastroenteropancreatic tumors. J Nucl Med 1997;38:853–858.
Eriksson B, Bergstrom M, Sundin A, Juhlin C, Orlefors H, Oberg K, et al. The role of PET in localization of neuroendocrine and adrenocortical tumors. Ann N Y Acad Sci 2002;970:159–169.
Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 2003;348:2500–2507.
Cohade C, Osman M, Leal J, Wahl RL. Direct comparison of (18)F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med 2003;44:1797–1803.
Nakamoto Y, Higashi T, Sakahara H, Tamaki N, Kogire M, Doi R, et al. Delayed (18)F-fluoro-2-deoxy-d-glucose positron emission tomography scan for differentiation between malignant and benign lesions in the pancreas. Cancer 2000;89:2547–2554.
Buetow PC, Parrino TV, Buck JL, Pantongrag-Brown L, Ros PR, Dachman AH, et al. Islet cell tumors of the pancreas: pathologic-imaging correlation among size, necrosis and cysts, calcification, malignant behavior, and functional status. AJR Am J Roentgenol 1995;165:1175–1179.
Sugiyama M, Abe N, Izumisato Y, Yamaguchi Y, Yamato T, Tokuhara M, et al. Differential diagnosis of benign versus malignant nonfunctioning islet cell tumors of the pancreas: the roles of EUS and ERCP. Gastrointest Endosc 2002;55:115–119.
Rodallec M, Vilgrain V, Couvelard A, Rufat P, O’Toole D, Barrau V, et al. Endocrine pancreatic tumours and helical CT: contrast enhancement is correlated with microvascular density, histoprognostic factors and survival. Pancreatology 2006;6:77–85.
Nakata B, Chung YS, Nishimura S, Nishihara T, Sakurai Y, Sawada T, et al. 18F-fluorodeoxyglucose positron emission tomography and the prognosis of patients with pancreatic adenocarcinoma. Cancer 1997;79:695–699.
Koyama K, Okamura T, Kawabe J, Nakata B, Chung KH, Ochi H, et al. Diagnostic usefulness of FDG PET for pancreatic mass lesions. Ann Nucl Med 2001;15:217–224.
Diederichs CG, Staib L, Glatting G, Beger HG, Reske SN. FDG PET: elevated plasma glucose reduces both uptake and detection rate of pancreatic malignancies. J Nucl Med 1998;39:1030–1033.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Toshikuni, N., Kai, K. & Fujisawa, M. Nonfunctioning endocrine pancreatic tumor examined with 18F-FDG PET/CT. Ann Nucl Med 22, 133–137 (2008). https://doi.org/10.1007/s12149-007-0085-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12149-007-0085-0