Metachronous Ectopic CRH-Secreting Tumors Detected by 68 Ga-Pentixafor PET/CT.

Yang, Yi; Zhang, Zhen; Li, Qingling; Li, Chun; Hu, Shuo · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 39-year-old woman with ACTH-dependent Cushing syndrome underwent pituitary surgery after bilateral inferior petrosal sinus sampling (BIPSS) suggested a central source; however, symptoms persisted, and pathology revealed an ACTH-negative adenoma, raising suspicion for ectopic corticotropin-releasing hormone (CRH) secretion. Subsequent 68 Ga-DOTATATE PET/CT was negative. CXCR4-targeted 68 Ga-Pentixafor PET/CT demonstrated focal intense uptake in a right neck lesion, confirmed as a CRH-secreting tumor by histopathology. Two years later, recurrence revealed a second anatomically distinct lesion in the right thigh, also histologically confirmed. This case highlights the value of 68 Ga-Pentixafor PET/CT in detecting metachronous ectopic CRH-secreting tumors.

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