Clinical History
The patient is a 66-year-old male with insulinoma, now being evaluated for evidence of recurrent and/or metastatic disease.
Technique
Whole body planar imaging was performed in the anterior and posterior projections at 4 and
24 hours following the uneventful intravenous administration of 5.5 mCi of 111In-Octreotide.
Findings
Comparison is made with the prior study dated 04/25/02 and the CT scan of the chest and abdomen dated 04/17/03.
1. There has been interval development of multiple foci of abnormal increased uptake within the hepatic parenchyma, appearing to involve both the right and left hepatic lobes.
2. There has been significant interval increase in the degree of abnormal activity evident within the mid upper abdomen and anterior mediastinum, just cephalad to the diaphragm.
3. At least three discrete new foci of abnormal increased activity are evident within the chest, one near the midline and one each occupying the lateral aspect of the thoracic cavity, bilaterally.
Impression
INTERVAL DEVELOPMENT OF MULTIPLE ABNORMAL FOCI OF INCREASED ACTIVITY WITHIN THE HEPATIC PARENCHYMA, INTERVAL DEVELOPMENT OF MULTIPLE FOCI OF ABNORMAL INCREASED ACTIVITY WITHIN THE THORACIC CAVITY, AND INTERVAL INCREASE IN ABNORMAL ACTIVITY WITHIN THE ANTERIOR MEDIASTINUM AND UPPER MID ABDOMEN. THESE FINDINGS ARE MOST COMPATIBLE WITH PROGRESSION OF METASTATIC DISEASE.