Osteoblastic bone metastases from neuroendocrine tumor (NET) of unknown origin detected by 18fluorocholine PET/CT and its comparison with 68gallium-DOTATOC PET/CT: Case report and review of the literature

Alberto Bongiovanni, Federica Recine, Monica Celli, Giulia Marcantognini, Flavia Foca, Chiara Liverani, Valentina Fausti, Alessandro De Vita, Giacomo Miserocchi, Laura Mercatali, Dino Amadori, Toni Ibrahim

Research output: Contribution to journalArticle

Abstract

RATIONALE: Choline (CH) positron emission tomography (PET)/computed tomography (CT) with fluorine 18 (F) CH is increasingly used not only to evaluate patients with biochemically recurrent prostate cancer but also to assess metastatic lesions that are difficult or impossible to identify using more conventional modalities. Our experience with CH PET/CT has shown that it can also be used for many other malignancies.

PRESENTING CONCERNS: A 71-year-old male with a neuroendocrine tumor (NET) of unknown origin showed osteoblastic bone metastases positive to F-CH PET.

INTERVENTIONS: Diffuse bone and liver metastases were gallium-DOTATOC PET-positive with only mild uptake on FDG PET/CT. An increased prostate specific antigen (8 μg/L) gave rise to a suspicion of concurrent prostate cancer and the patient underwent F-CH PET/CT which showed diffuse uptake in the bone. A CT-guided bone biopsy confirmed osteoblastic bone metastases from NET.

OUTCOMES: Given the aggressiveness of the tumor, the patient underwent treatment with temozolomide from July 2015 to December 2015, maintaining stable disease. However, progression was documented in January 2016 and the patient was enrolled onto a phase II peptide receptor radionuclide therapy retreatment trial, which is currently ongoing.

MAIN LESSON: Our study highlights that NETs should be taken into consideration in the differential diagnosis of osteoblastic bone metastases showing F-CH uptake. A prognostic role for this imaging technique can also be hypothesized.

Original languageEnglish
Pages (from-to)e8567
JournalMedicine
Volume96
Issue number46
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Neuroendocrine Tumors
Choline
Neoplasm Metastasis
Bone and Bones
temozolomide
Positron-Emission Tomography
Prostatic Neoplasms
Gallium
Retreatment
Peptide Receptors
Fluorine
Prostate-Specific Antigen
Radioisotopes
Positron Emission Tomography Computed Tomography
Edotreotide
Neoplasms
Differential Diagnosis
Tomography
Biopsy
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{01385ce5d13740cc90eeb3fcfcd6432b,
title = "Osteoblastic bone metastases from neuroendocrine tumor (NET) of unknown origin detected by 18fluorocholine PET/CT and its comparison with 68gallium-DOTATOC PET/CT: Case report and review of the literature",
abstract = "RATIONALE: Choline (CH) positron emission tomography (PET)/computed tomography (CT) with fluorine 18 (F) CH is increasingly used not only to evaluate patients with biochemically recurrent prostate cancer but also to assess metastatic lesions that are difficult or impossible to identify using more conventional modalities. Our experience with CH PET/CT has shown that it can also be used for many other malignancies.PRESENTING CONCERNS: A 71-year-old male with a neuroendocrine tumor (NET) of unknown origin showed osteoblastic bone metastases positive to F-CH PET.INTERVENTIONS: Diffuse bone and liver metastases were gallium-DOTATOC PET-positive with only mild uptake on FDG PET/CT. An increased prostate specific antigen (8 μg/L) gave rise to a suspicion of concurrent prostate cancer and the patient underwent F-CH PET/CT which showed diffuse uptake in the bone. A CT-guided bone biopsy confirmed osteoblastic bone metastases from NET.OUTCOMES: Given the aggressiveness of the tumor, the patient underwent treatment with temozolomide from July 2015 to December 2015, maintaining stable disease. However, progression was documented in January 2016 and the patient was enrolled onto a phase II peptide receptor radionuclide therapy retreatment trial, which is currently ongoing.MAIN LESSON: Our study highlights that NETs should be taken into consideration in the differential diagnosis of osteoblastic bone metastases showing F-CH uptake. A prognostic role for this imaging technique can also be hypothesized.",
author = "Alberto Bongiovanni and Federica Recine and Monica Celli and Giulia Marcantognini and Flavia Foca and Chiara Liverani and Valentina Fausti and {De Vita}, Alessandro and Giacomo Miserocchi and Laura Mercatali and Dino Amadori and Toni Ibrahim",
year = "2017",
month = "11",
day = "1",
doi = "10.1097/MD.0000000000008567",
language = "English",
volume = "96",
pages = "e8567",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "46",

}

TY - JOUR

T1 - Osteoblastic bone metastases from neuroendocrine tumor (NET) of unknown origin detected by 18fluorocholine PET/CT and its comparison with 68gallium-DOTATOC PET/CT

T2 - Case report and review of the literature

AU - Bongiovanni, Alberto

AU - Recine, Federica

AU - Celli, Monica

AU - Marcantognini, Giulia

AU - Foca, Flavia

AU - Liverani, Chiara

AU - Fausti, Valentina

AU - De Vita, Alessandro

AU - Miserocchi, Giacomo

AU - Mercatali, Laura

AU - Amadori, Dino

AU - Ibrahim, Toni

PY - 2017/11/1

Y1 - 2017/11/1

N2 - RATIONALE: Choline (CH) positron emission tomography (PET)/computed tomography (CT) with fluorine 18 (F) CH is increasingly used not only to evaluate patients with biochemically recurrent prostate cancer but also to assess metastatic lesions that are difficult or impossible to identify using more conventional modalities. Our experience with CH PET/CT has shown that it can also be used for many other malignancies.PRESENTING CONCERNS: A 71-year-old male with a neuroendocrine tumor (NET) of unknown origin showed osteoblastic bone metastases positive to F-CH PET.INTERVENTIONS: Diffuse bone and liver metastases were gallium-DOTATOC PET-positive with only mild uptake on FDG PET/CT. An increased prostate specific antigen (8 μg/L) gave rise to a suspicion of concurrent prostate cancer and the patient underwent F-CH PET/CT which showed diffuse uptake in the bone. A CT-guided bone biopsy confirmed osteoblastic bone metastases from NET.OUTCOMES: Given the aggressiveness of the tumor, the patient underwent treatment with temozolomide from July 2015 to December 2015, maintaining stable disease. However, progression was documented in January 2016 and the patient was enrolled onto a phase II peptide receptor radionuclide therapy retreatment trial, which is currently ongoing.MAIN LESSON: Our study highlights that NETs should be taken into consideration in the differential diagnosis of osteoblastic bone metastases showing F-CH uptake. A prognostic role for this imaging technique can also be hypothesized.

AB - RATIONALE: Choline (CH) positron emission tomography (PET)/computed tomography (CT) with fluorine 18 (F) CH is increasingly used not only to evaluate patients with biochemically recurrent prostate cancer but also to assess metastatic lesions that are difficult or impossible to identify using more conventional modalities. Our experience with CH PET/CT has shown that it can also be used for many other malignancies.PRESENTING CONCERNS: A 71-year-old male with a neuroendocrine tumor (NET) of unknown origin showed osteoblastic bone metastases positive to F-CH PET.INTERVENTIONS: Diffuse bone and liver metastases were gallium-DOTATOC PET-positive with only mild uptake on FDG PET/CT. An increased prostate specific antigen (8 μg/L) gave rise to a suspicion of concurrent prostate cancer and the patient underwent F-CH PET/CT which showed diffuse uptake in the bone. A CT-guided bone biopsy confirmed osteoblastic bone metastases from NET.OUTCOMES: Given the aggressiveness of the tumor, the patient underwent treatment with temozolomide from July 2015 to December 2015, maintaining stable disease. However, progression was documented in January 2016 and the patient was enrolled onto a phase II peptide receptor radionuclide therapy retreatment trial, which is currently ongoing.MAIN LESSON: Our study highlights that NETs should be taken into consideration in the differential diagnosis of osteoblastic bone metastases showing F-CH uptake. A prognostic role for this imaging technique can also be hypothesized.

UR - http://www.scopus.com/inward/record.url?scp=85040523527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040523527&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000008567

DO - 10.1097/MD.0000000000008567

M3 - Article

C2 - 29145267

AN - SCOPUS:85040523527

VL - 96

SP - e8567

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 46

ER -