Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Failure of functional imaging with gallium-68DOTA-D-Phe1-Tyr3-octreotide positron emission tomography to localize the site of ectopic adrenocorticotropic hormone secretion: a case report | Gani et al. Journal of Medical Case Reports 2011 5 405 http content 5 1 405 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Failure of functional imaging with gallium-68-DOTA-D-Phe1-Tyr3-octreotide positron emission tomography to localize the site of ectopic adrenocorticotropic hormone secretion a case report 1111 Linsey U Gani Emily J Gianatti Ada S Cheung George Jerums and Richard J MacIsaac Abstract Introduction The diagnostic efficacy of biochemical and imaging modalities for investigating the causes of Cushing s syndrome are limited. We report a case demonstrating the limitations of these modalities especially the inability of functional imaging to help localize the site of ectopic adrenocorticotropic hormone secretion. Case presentation A 37-year-old Arabian woman presented with 12 months of progressive Cushing s syndromelike symptoms. Biochemical evaluation confirmed adrenocorticotropic hormone -dependent Cushing s syndrome. However the anatomical site of her excess adrenocorticotropic hormone secretion was not clearly delineated by further investigations. Magnetic resonance imaging of our patient s pituitary gland failed to demonstrate the presence of an adenoma. Spiral computed tomography of her chest only revealed the presence of a non-specific 7 mm lesion in her left inferobasal lung segment. Functional imaging including a positron emission tomography scan using 18-fluorodeoxyglucose and gallium-68-DOTA-D-Phe1-Tyr3-octreotide also failed to show increased metabolic activity in the lung lesion or in her pituitary gland. Our patient was commenced on medical treatment with ketoconazole and metyrapone to control the clinical features associated with her excess cortisol secretion. Despite initial normalization of her urinary free cortisol excretion rate levels began to rise eight months after commencement of medical treatment. Repeated imaging of her pituitary gland chest and pelvis again failed to clearly localize a
