Faculty Bibliography

Ga-DOTATATE, a positron-emitting somatostatin analog, has been approved by the Food and Drug Administration for imaging neuroendocrine tumors (NETs). The presence of a second primary malignancy is common in NETs; however, synchronous primary malignancy in the thyroid has rarely been reported. The value of Ga-DOTATATE in medullary thyroid cancer is being investigated and is currently recommended for use when treatment with somatostatin analogs is an option. We present a 55-year-old man with abdominal pain associated with well-differentiated NET liver metastases and incidental medullary thyroid carcinoma demonstrated on a Ga-DOTATATE PET/CT.

Orbital metastasis is an uncommon and atypical presentation of recurrent esophageal cancer that has been only seldom reported in literature. F-FDG PET/CT is routinely performed for staging and response assessment in patients with esophageal carcinoma. This case demonstrates use of follow-up FDG PET/CT scans in characterizing solitary metastatic disease in orbit and in evaluating response to therapy. It also highlights a key teaching point that postradiation-related inflammatory/infective changes may interfere in accurate assessment of PET/CT scan; however, frequently used clinical and radiological correlation may not be entirely sufficient to rule out pathological involvement.

F-FDG PET/CT is a sensitive noninvasive imaging tool for assessment of recurrent disease in patients with carcinoma cervix. Its role in early detection of recurrences especially in asymptomatic patients has been demonstrated well in literature. Metastatic involvement of the pancreas in patients with adenocarcinoma of the cervix is a rare occurrence, reported only few times in literature, and is predominantly documented to be associated with uncommon histopathologies such as neuroendocrine and small cell carcinoma. We report a rare asymptomatic case of adenocarcinoma of the cervix, detected and confirmed to have pancreatic metastasis on surveillance FDG PET/CT imaging.

Multifocal osteosarcoma is usually defined as the occurrence of a tumor at 2 or more sites in a patient without pulmonary metastases and may be synchronous with more than one lesion seen at presentation or metachronous with new tumors developing after the initial treatment. It is difficult to determine whether these represent synchronous multiple primary lesions or metastases. We present a rare case of widespread synchronous multifocal osteosarcoma and a brief review of the literature.