Uptake of 123I-metaiodobenzylguanidine by gastrointestinal stromal tumor

Bhanthumkomol, Patommatat; Hijioka, Susumu; Mizuno, Nobumasa; Kuwahara, Takamichi; Okuno, Nozomi; Ito, Ayako; Tanaka, Tsutomu; Ishihara, Makoto; Hirayama, Yutaka; Onishi, Sachiyo; Niwa, Yasumasa; Tajika, Masahiro; Ito, Y.; Sasaki, Eiichi; Inaba, Yoshitaka; Shimizu, Yasuhiro; Yatabe, Yasushi; Hara, Kazuo

doi:10.1007/s12328-017-0743-2

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…It has been reported that 123 I-MIBG may accumulate not only in neuroendocrine tumors but also in angiomyolipomas, renal cell carcinomas, hepatocellular carcinomas, adrenocortical adenomas, and adrenocortical carcinomas. Four GISTs with false-positive 123 I-MIBG scintigraphy findings have been previously described ( 6 ) ( Table 2 ). There were no relationships between the patient age, sex, or symptoms.…”

Section: Discussionmentioning

confidence: 96%

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False-positive 123I-metaiodobenzylguanidine scintigraphy in a patient with a gastrointestinal stromal tumor presenting as a left adrenal incidentaloma

Sugito

Tanabe

Maruyama

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary A 47-year-old man was diagnosed with a left adrenal incidentaloma at 40 years of age. The tumor had irregular margins and grew from 18 mm to 30 mm in maximum diameter over 7 years. On computed tomography scan, the mass appeared to localize within the tip of the lateral limb of the left adrenal gland, and between the left adrenal gland and the posterior wall of the stomach. The plasma corticotropin and cortisol concentrations and the 24-h urine fractionated metanephrine levels were normal. 123I-metaiodobenzylguanidine scintigraphy showed tumor avidity consistent with a hormonally inactive pheochromocytoma. A laparoscopic left adrenalectomy was performed; however, no tumor was present in the resected specimen. Abdominal computed tomography postoperatively showed that the tumor remained intact and appeared to connect to the posterior wall of the stomach. A laparotomy was performed and the tumor was removed. The tumor was localized to the intraperitoneal space and isolated from the posterior wall of the stomach. The pathological diagnosis was a gastrointestinal stromal tumor. Clinicians need to be aware of the limitations of diagnostic imaging studies in diagnosing non-functioning adrenal incidentalomas, which require a pathological analysis for the final diagnosis. Moreover, clinicians need to provide patients with sufficient informed consent when deciding on treatment strategies. Learning points Anatomic structures and tumors that develop in neighboring tissues to the adrenal glands may be confused with primary adrenal tumors. 123I- metaiodobenzylguanidine (MIBG) scintigraphy is specific for diagnosing pheochromocytomas and paragangliomas; however, it has been reported that 123I-MIBG may accumulate in neuroendocrine tumors as well as other tumors. Clinicians should recognize the limitations of imaging studies and the uncertainty of an imaging-based preoperative diagnosis.

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Section: Discussionmentioning

confidence: 96%

“…The following two theories are considered the mechanisms underlying MIBG accumulation in GISTs ( 6 , 7 ). First, GISTs are believed to arise from interstitial cells of Cajal (ICCs).…”

Section: Discussionmentioning

confidence: 99%

False-positive 123I-metaiodobenzylguanidine scintigraphy in a patient with a gastrointestinal stromal tumor presenting as a left adrenal incidentaloma

Sugito

Tanabe

Maruyama

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…MIBG scintigraphy is an effective diagnostic tool for the investigation of the cause of parkinsonism 1 and tumors, including paraganglioma, pheochromocytoma, and neuroblastoma, 2–4 because they originate from sympathetic ganglion cells. Other reports have described other tumors that show uptake of MIBG, including adrenocortical adenoma/carcinoma, hepatocellular carcinoma, and gastrointestinal stromal tumors 5–8 . Although lymphoma involving the adrenal gland is reported to demonstrate the uptake of MIBG, 9 it is not established that lymphoma in organs other than the adrenal glands shows increased uptake of MIBG.…”

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confidence: 99%

“…Other reports have described other tumors that show uptake of MIBG, including adrenocortical adenoma/carcinoma, hepatocellular carcinoma, and gastrointestinal stromal tumors. [5][6][7][8] Although lymphoma involving the adrenal gland is reported to demonstrate the uptake of MIBG, 9 it is not established that lymphoma in organs other than the adrenal glands shows increased uptake of MIBG. Here, we report a case of DLBCL showing the uptake of MIBG despite the absence of adrenal involvement.…”

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confidence: 99%

Diffuse Large B-cell Lymphoma

Sakurada

Koyasu

Sugimoto³

et al. 2021

Clin Nucl Med

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A 77-year-old man with parkinsonism was referred to the department of neurology for further examination. Cardiac 123I-MIBG scintigraphy unexpectedly showed strong uptake in the left shoulder, suggestive of MIBG-avid tumors including paraganglioma. MRI revealed multiple nodules suggestive of lymphoma. A biopsy was performed, which led to the pathological diagnosis of diffuse large B-cell lymphoma. Cardiac MIBG scintigraphy sometimes shows unexpected findings outside the mediastinum. In addition, lymphoma should also be added to the list of differential diagnoses for MIBG-positive tumors.

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“…However, false-positive findings do occur in many different situations 6–8 . MIBG uptake in GIST have been reported before 9,10 . Recognizing abnormal activity caused by gastric GIST is important because gastric MIBG activity can be a normal variant 11 .…”

mentioning

confidence: 99%