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Endocrine. 2013 Aug;44(1):264-5. doi: 10.1007/s12020-013-9946-6. Epub 2013 Apr 7.

Metabolic response demonstrated by 18F-FDG-PET/CT in metastatic medullary thyroid carcinoma under sorafenib therapy.

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  • 1Nuclear Medicine Department, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Avda. Valdecilla, s/n, 39008, Santander, Spain. mimartinez@humv.es

Abstract

A 51-year-old woman with a medullary thyroid carcinoma (MTC) presented with a palpable nodule in the right breast. Serum calcitonin was 1,453 pg/ml and carcinoembryonic antigen was 201 ng/ml. Cervical ultrasound and bone scintigraphy were normal. Computed tomography (CT) showed nodules in the right breast and anterior thoracic wall and a hypodense lesion in the right hepatic lobe. Histology of the breast nodule confirmed metastasis from MTC. To evaluate the metabolic activity of these lesions, 18F-fluorodeoxiglucose positron emission tomography-CT (FDG-PET/CT) scan was requested. Axial fused images revealed high FDG uptake by the breast and thoracic wall nodules and the right hepatic lobe. FDG-PET/CT also showed uptake in sacrum and right iliac bone, undetected by CT and bone scintigraphy. After seven cycles of sorafenib PET/CT became negative. Calcitonin decreased to 82.5. A PET/CT performed 6 months later remained negative. This is the first published image of the complete metabolic response of MTC to sorafenib therapy using FDG-PET/CT.

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