Somatostatin Receptor Scintigraphy and Therapy of Neuroendocrine (APUD) Tumors of the Head and Neck

Abstract

Through the development of somatostatin scintigraphy with the labeled somatostatin analog Indium111-Octreotide, it has recently become possible to accurately diagnose primary tumors of the APUD system as well as their metastases, since these tumors usually have somatostatin receptors. Experience with this method is already available for endocrine and exocrine tumors of the gastrointestinal tract, neuroendocrine and breast tumors, small cell bronchial carcinomas and certain lymphomas. In the present study, this new diagnostic technique was used for the first time in various head and neck tumors (carcinoid of the larynx, Merkel cell tumor, glomus tumor of the carotid and glomus jugulare tumor). Concurrently, some of these tumors shown by this diagnostic method to be somatostatin receptor positive were treated using the somatostatin analog Octreotide, a therapeutic approach new for the ENT-specialty. Our initial results prove that the detection of the ENT tumors which we studied by means of receptor scintigraphy is reliable. The preliminary results of this Octreotide therapy show a growth inhibitory effect, especially for those tumors of the head and neck which are inoperable or are difficult to approach surgically.

Somatostatin Therapy for Glomus Tumors: A Report of Two Cases

“…In some cases, the size of the tumors even decreased. 11 The possibility of delivering a therapeutic dose of radiation to receptor-bearing tumors by administering specific radiolabeled somatostatin analogues also exists.16 '17 In our first patient, the tumor was deemed inoperable and the patient continued to be symptomatic after completing radiation therapy. This poor response, combined with evidence of a slight increase in size ofthe tumor on MRI scan and considerable brainstem compression, led us to offer somatostatin therapy.…”

Complex Glomus Jugulare Tumor: Management Issues

“…Treatment with radioactivity labeled somatostatin analogue octreotide has been noted to arrest tumor growth over 3-5 years [25,26]. Such treatment has the potential to supplement or replace radiation therapy and stereotactic radiation in the future.…”

Laryngeal Neuroendocrine Tumour: A Rare Case Report and Review of Literature

“…Though paragangliomas show raised levels of urinary catecholamine, vanillylmandelic and homovanillic acid; increased levels of 5-HIAA, NSE and CgA can be diagnostic for carcinoid. Octreotide Scanning with Indium-111 pentetreotide may be suggestive of somatostatin receptors in tumour cells that can be amenable to radio metabolic treatment [18]. NETs of the larynx are rarely associated with clinically evident hormonal activity and elevated levels of circulating catecholamines and their derivatives, calcitonin and urinary 5-HIAA, are uncommon, mostly due to the reduced or absent secretion or release of hormonal substances with qualitative or quantitative anomalies [19].…”