18 F-FDG PET/CT and 68 Ga-DOTA-NOC PET/MRI in an Adolescent With Ectopic Adrenocorticotropic Hormone Syndrome From a Presacral Teratoma.
case_report · Level V
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- Record sourced from PubMed, PMID 41400990.
- Also identified by DOI 10.1097/RLU.0000000000006268.
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Abstract
A 13-year-old girl with severe Cushingoid features had ectopic ACTH-dependent Cushing syndrome. 18 F-FDG PET/CT demonstrated diffusely FDG-avid bilateral adrenal hyperplasia, confirming ectopic ACTH stimulation, and detected a presacral mass with mild uptake. 68 Ga-DOTA-NOC PET/MRI revealed intense somatostatin-receptor activity (SUVmax: 56.1), and MRI identified fat and cystic elements, suggesting teratoma. Surgery proved a mature teratoma harboring an ACTH-secreting NET (G1). This rare case demonstrates that in pediatric patients with aggressive-appearing presacral masses and life-threatening hypercortisolism, complementary imaging modalities may be necessary to exclude malignancy while identifying the functional tumor source.
Medical subject headings
- Fluorodeoxyglucose F18
- Magnetic Resonance Imaging
- Organometallic Compounds
- Positron Emission Tomography Computed Tomography
- Teratoma
- ACTH Syndrome, Ectopic
- Multimodal Imaging
- Positron-Emission Tomography
- Tomography, X-Ray Computed