RESUMEN
A 30-year-old woman had a history of prolactinoma and primary hyperparathyroidism. She was diagnosed as having multiple endocrine neoplasia type 1 with gastrinoma and liver metastases. Octreotide therapy was started and the serum gastrin level decreased immediately. Octreotide continued to suppress gastrin secretion over the next 7 years. The Ki67/MIB1 proliferation index of this tumor was only 0.5 % and somatostatin receptor (SSTR) 2 expression was very strong in both 2002 and 2009. This case suggests the importance of investigating the Ki67/MIB1 index and SSTR expression in patients with metastatic gastrinoma.
Asunto(s)
Gastrinoma/tratamiento farmacológico , Neoplasia Endocrina Múltiple Tipo 1/tratamiento farmacológico , Octreótido/administración & dosificación , Neoplasias Pancreáticas/tratamiento farmacológico , Adulto , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Gastrinoma/diagnóstico , Humanos , Neoplasia Endocrina Múltiple Tipo 1/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Factores de TiempoRESUMEN
A 51-year-old woman was hospitalized with a high fever, occipital pain, blepharoptosis, and trismus. Enhanced CT showed thrombophlebitis of her left cavernous sinus, maxillary vein, and multiple pulmonary nodular lesions. (18)F-FDG PET/CT showed significant uptakes in the same lesions. Streptococcus constellatus was detected in her blood. Therefore, she was diagnosed as a Lemierre syndrome variant. After administration of antibiotics, all symptoms, inflammatory reactions, and thrombi disappeared. Since Lemierre syndrome has life-threatening potential, early diagnosis and initiation of appropriate therapy are important. In this case, (18)F-FDG PET/CT was useful to detect the focus and extent of infection.
