Octreotide Case 7

Details on the Request Card

37 year old female. Known medullary cell carcinoma of the thyroid, previously resected. Patient presents in status epilepticus with probably brain metastases on CT. The oncologist wishes to know if there is more disseminated disease or is she fit for localized resection or radiotherapy.

Procedure

Anterior and posterior images are shown, 24hrs after injection

scan image

Questions

1) Is there any evidence of metastatic disease?
2) Explain the rationale behind the choice of radiopharmaceutical
3) Explain why serum calcitonin levels may be high
4) If the patient was less than 20, what underlying syndrome should you consider and why is this important?

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The text is entirely the opinion of the author and does not necessarily reflect that of RUH NHS Trust or the Bristol Radiology Training Scheme. Website content devised by Paul McCoubrie.