RESUMEN
Aim: Tumor markers often remain elevated after intended curative resection of medullary thyroid carcinoma (MTC). The aim of this study was to determine the expression of αvß3, a promising theranostics target, in MTC and its metastases. Materials & methods: Avß3 expression was analyzed in 104 patients using a tissue microarray and correlated with clinicopathological variables and survival. Results: Cytoplasmic αvß3 positivity was seen in 70 patients and was associated with lymph node metastases at time of initial surgery. Membranous positivity was considered positive in 30 patients and was associated with sporadic MTC. Conclusion: Avß3 was expressed in the cytoplasm of 67% of MTC patients. Membranous expression, which is presumably most relevant for the theranostic use of αvß3, was seen in 29%.
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RESUMEN
Intravenous 177Lu-high-affinity (HA)-DOTATATE has shown promising results for the treatment of surgery- and radiotherapy-refractory meningiomas. We aimed to investigate the added value of intraarterial administration. Methods: Patients underwent at least 1 intravenous 177Lu-HA-DOTATATE treatment first and subsequent intraarterial cycles. Inpatient and intrapatient comparison was based on posttreatment 177Lu-HA-DOTATATE imaging 24 h after injection. The technical success rate and adverse events were recorded. Results: Four patients provided informed consent. The technical success rate was 100%, and no angiography-related or unexpected adverse events occurred. Intrapatient comparison showed an increased target lesion accumulation on both planar imaging (mean, +220%) and SPECT/CT (mean, +398%) after intraarterial administration, compared with intravenous administration. No unexpected adverse events occurred during follow-up. Conclusion: Intraarterial peptide receptor radionuclide therapy significantly increases tracer accumulation and is a safe and promising improvement for salvage meningioma patients. Future prospective studies on intraarterial peptide receptor radionuclide therapy are needed to determine the gain in efficacy and survival.
Asunto(s)
Neoplasias Meníngeas , Meningioma , Tumores Neuroendocrinos , Compuestos Organometálicos , Radioisótopos de Galio , Humanos , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/radioterapia , Meningioma/diagnóstico por imagen , Meningioma/radioterapia , Tumores Neuroendocrinos/patología , Octreótido/efectos adversos , Compuestos Organometálicos/uso terapéutico , Tomografía de Emisión de Positrones , Estudios Prospectivos , Cintigrafía , Radiofármacos , Receptores de PéptidosRESUMEN
We report a case of a 65-year-old patient with muscle invasive bladder cancer that was treated with neoadjuvant chemotherapy, followed by radical cystoprostatectomy with pelvic lymph node dissection and orthotopic neobladder according to Hautmann. Nine years later, routine follow-up showed local recurrence in the neobladder and metastatic disease of the urothelial carcinoma in the related mesenteric lymph nodes. The entire neobladder specimen was removed including the mesentery of the neobladder. Based on the anatomical lymph drainage of the ileal neobladder, we considered the metastatic disease in the mesentery lymph node as locoregional disease spread. This case shows that such locoregional lymph node metastasis may be amenable to treatment by induction chemotherapy and radical surgery.