scholarly journals Intrapancreatic accessory spleen mimicking malignant tumor: three case reports

2019 ◽  
Vol 8 (6) ◽  
pp. 205846011985934 ◽  
Author(s):  
Maria Zurek Munk-Madsen ◽  
Kristine Zakarian ◽  
Peter Sandor Oturai ◽  
Carsten Palnæs Hansen ◽  
Birgitte Federspiel ◽  
...  
Keyword(s):  
Single Photon ◽  
Case Reports ◽  
False Negative ◽  
Photon Emission ◽  
Accessory Spleen ◽  
Splenic Tissue ◽  
Emission Computed Tomography ◽  
Intrapancreatic Accessory Spleen ◽  
Photon Emission Computed Tomography ◽  
Accessory Spleens

Intrapancreatic hypervascular lesions may represent metastases, neuroendocrine tumors, or intrapancreatic accessory spleens. The benign intrapancreatic accessory spleen can be difficult to separate from a malignant neuroendocrine tumor or metastasis. We report three cases of pancreatic lesions that underwent pancreatic surgery due to suspicion of malignancy on imaging; all cases were histologically intrapancreatic accessory spleens. Our cases point to the importance of performing single-photon emission computed tomography with heat-damaged Tc-99m-pertechnetate labelled erythrocytes to identify splenic tissue, even though small lesions can show a false-negative result.

scholarly journals False-negative 123I-MIBG SPECT is most commonly found in SDHB-related pheochromocytoma or paraganglioma with high frequency to develop metastatic disease

2011 ◽  
Vol 19 (1) ◽  
pp. 83-93 ◽  
Author(s):  
Jay S Fonte ◽  
Jeremyjones F Robles ◽  
Clara C Chen ◽  
James Reynolds ◽  
Millie Whatley ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Single Photon ◽  
False Negative ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Tumor Diameter ◽  
Metastatic Tumors ◽  
Primary Tumors ◽  
Photon Emission Computed Tomography

The purpose of this study was to present the characteristics and outcome of patients with proven pheochromocytoma or paraganglioma who had false-negative iodine-123 metaiodobenzylguanidine single photon emission computed tomography (123I-MIBG SPECT). Twenty-one patients with false-negative 123I-MIBG SPECT (7 males, 14 females), aged 13–55 years (mean: 41.40 years), were included. We classified them as nonmetastatic or metastatic according to the stage of the disease at the time of false-negative 123I-MIBG SPECT study, the location and size of the tumor, plasma and urinary catecholamine and metanephrine levels, genetic mutations, and outcome in terms of occurrence and progression of metastases and death. Thirteen patients were evaluated for metastatic tumors, while the remaining eight were seen for nonmetastatic disease. All primary tumors and multiple metastatic foci did not show avid 123I-MIBG uptake regardless of the tumor diameter. The majority of patients had extraadrenal tumors with hypersecretion of normetanephrine or norepinephrine. SDHB mutations were present in 52% (n=11) of cases, RET mutation in 4% (n=1), and the rest were apparently sporadic. Twenty-four percent (n=5) had metastatic disease on initial presentation. Fourteen patients were followed for 3–7 years. Of them, 71% (n=10) had metastatic disease and the majority had SDHB mutations. Nine are still alive, while five (four with SDHB) died due to metastatic disease. We concluded that false-negative 123I-MIBG SPECT is frequently related to metastatic tumors and usually due to SDHB mutations with unfavorable prognosis. We therefore recommend that patients with false-negative 123I-MIBG SPECT be tested for SDHB mutations and undergo more regular and close follow-up.

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