Medullary Thyroid Carcinoma presenting as an Incidentaloma on Gallium-68-PSMA-PET/CT – Systematic Literature Review and Case Report

Introduction

The prostate-specific membrane antigen (PSMA) is established in imaging and treatment of prostate cancer, especially in recurrent disease. PSMA is a membrane-bound glycoprotein with the function of a glutamic acid releasing carboxypeptidase enzyme, which is biologically expressed by the prostate and among others, proximal renal tubule cells, small intestine, central and peripheral nervous system [1]. Positrone Emission Tomography (PET)/ Computed Tomography (CT) imaging with Gallium (Ga)-68 in prostate cancer has its benefits in demonstrating the extent of the current disease and in preceding possible therapy with radionuclides like Lutetium (Lu)-177 and also the feasibility of intraoperative probe-assisted detection and localization of respective lesions.

Publikationsverlauf

Eingereicht: 08. Oktober 2020

Angenommen nach Revision: 07. Juli 2022

Artikel online veröffentlicht:
11. August 2022

• References

• 1 Barinka C, Sacha P, Sklenar J. et al. Identification of the N-glycosylation Sites on Glutamate Carboxypeptidase II Necessary for Proteolytic Activity. Protein Sci 2004; 13 (06) 1627-1635
• 2 Van de Wiele C, Sathekge M, de Spiegeleer B. et al. PSMA expression on neovasculature of solid tumors. Histol Histopathol 2020; 35 (09) 919-927
• 3 Kinoshita Y, Kuratsukuri K, Landas S. et al. Expression of prostatespecific membrane antigen in normal and malignant human tissues. World J Surg 2006; 30: 628636
• 4 Zacho HD, Nielsen JB, Dettmann K. et al. Incidental detection of thyroid metastases from renal cell carcinoma using 68Ga-PSMA PET/CT to assess prostate cancer recurrence. Clin Nucl Med 2017; 42: 221-222
• 5 Huang YT, Fong W, Thomas P. Rectal carcinoma on 68Ga-PSMA PET/CT. Clin Nucl Med 2016; 41: 167-168
• 6 Shetty D, Loh H, Bui C. et al. Elevated 68Ga prostate-specific membrane antigen activity in metastatic non-small cell lung cancer. Clin Nucl Med 2016; 41: 414-416
• 7 Taneja S, Taneja R, Kashyap V. et al. 68GaPSMA uptake in hepatocellular carcinoma. Clin Nucl Med 2017; 42: 6970
• 8 Sasikumar A, Joy A, Pillai MR. et al. 68GaPSMA PET/CT imaging in multiple myeloma. Clin Nucl Med 2017; 42: 126127
• 9 Vamadevan S, Shetty D, Le K. et al. Prostate-specific membrane antigen (PSMA) avid pancreatic neuroendocrine tumor. Clin Nucl Med 2016; 41: 804-806
• 10 Kanthan GL, Coyle L, Kneebone A. et al. Follicular lymphoma showing avid uptake on 68Ga PSMA-HBED-CC PET/CT. Clin Nucl Med 2016; 41: 500-501
• 11 Damle NA, Tripathi M, Chakraborty PS. et al. Unusual uptake of prostate specific tracer 68Ga-PSMA-HBED-CC in a benign thyroid nodule. Nucl Med Mol Imaging 2016; 50: 344-347
• 12 Chang SS, Reuter VE, Heston WD. et al. Five different anti-prostate-specific membrane antigen (PSMA) antibodies confirm PSMA expression in tumorassociated neovasculature. Cancer Res 1999; 59: 3192-3198
• 13 Taywade SK, Damle NA, Bal CS. PSMA expression in papillary thyroid carcinoma opening a new horizon in management of thyroid cancer?. Clin Nucl Med 2016; 41: 263-265
• 14 Osman MM, Iravani A, Hicks RJ. et al. Detection of synchronous primary malignancies with 68Ga-labeled prostate-specific membrane antigen PET/CT in patients with prostate cancer: frequency in 764 patients. J Nucl Med 2017; 58: 1938-1942
• 15 Heitkötter B, Steinestel K, Trautmann M. et al. Neovascular PSMA expression is a common feature in malignant neoplasms of the thyroid. Oncotarget 2018; 9 (11) 9867-9874
• 16 Haffner MC, Laimer J, Chaux A. et al. High expression of prostate-specific membrane antigen in the tumor-associated neo-vasculature is associated with worse prognosis in squamous cell carcinoma of the oral cavity. Mod Pathol 2012; 25 (08) 1079-1085
• 17 Jiao D, Li Y, Yang F. et al. Expression of Prostate-Specific Membrane Antigen in Tumor-Associated Vasculature Predicts Poor Prognosis in Hepatocellular Carcinoma. Clin Transl Gastroenterol 2019; 10 (05) 1-7
• 18 Sollini M, di Tommaso L, Kirienko M. et al. PSMA expression level predicts differentiated thyroid cancer aggressiveness and patient outcome. EJNMMI Res 2019; 9 (01) 93
• 19 Forssell-Aronsson EB, Nilsson O, Bejegard SA. et al. 111In-DTPA-D-Phe1-octreotide binding and somatostatin receptor subtypes in thyroid tumors. J Nucl Med 2000; 41 (04) 636-642
• 20 Iten F, Muller B, Schindler C. et al. Response to (90)Yttrium-DOTATOC treatment is associated with long-term survival benefit in metastasized medullary thyroid cancer: A phase II clinical trial. Clin Cancer Res 2007; 13 (22) 6696-6702
• 21 Beukhof CM, Brabander T, van Nederveen FH. et al. Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls. BMC Cancer 2019; 19 (01) 325
• 22 Budiawan H, Salavati A, Kulkarni HR. et al. Peptide receptor radionuclide therapy of treatmentrefractory metastatic thyroid cancer using (90)Yttrium and (177)Lutetium labeled somatostatin analogs: toxicity, response and survival analysis. Am J Nucl Med Mol Imaging 2013; 4 (01) 39-52
• 23 Scalorbi F, Filice F, Sollini M. et al. Peptide receptor radionuclide Therapy (PRRT) in metastatic thyroid tumors: an opportunity after traditional treatment failure. Clin Transl Imaging 2017; 5 (01) 100
• 24 Bertagna F, Giubbini R, Savelli G. et al. A patient with medullary thyroid carcinoma and right ventricular cardiac metastasis treated by Y-90-Dotatoc. Hell J Nucl Med 2009; 12 (02) 161-164
• 25 Bodei L, Handkiewicz-Junak D, Grana C. et al. Receptor radionuclide therapy with 90Y-DOTATOC in patients with medullary thyroid carcinomas. Cancer biother Radiopharm 2004; 19 (01) 65-71
• 26 Gao ZR, Biersack HJ, Ezziddin S. et al. The role of combined imaging in metastatic medullary thyroid carcinoma: In-111-DTPA-octreotide and I-131/I-123-MIBG as predictors for radionuclide therapy. J Cancer Res Clin Oncol 2004; 130 (11) 649-656
• 27 Makis W, McCann K, McEwan AJ. Medullary thyroid carcinoma (MTC) treated with 177Lu-DOTATATE PRRT: a report of two cases. Clin Nucl Med 2015; 40 (05) 408-412
• 28 Vaisman F, Rosado de Castro PH, Lopes FP. et al. Is there a role for peptide receptor radionuclide therapy in medullary thyroid cancer?. Clin Nucl Med 2015; 40 (02) 123-127
• 29 Hayes AR, Crawford A, Al Riyami K. et al. Metastatic medullary thyroid cancer (MTC): Is there a role for peptide receptor radionuclide therapy (PRRT)?. Neuroendocrinology 2019; 108: 273
• 30 Puranik A, Baum RP, Kulkarni H. et al. Peptide receptor radionuclide therapy using 177Lu and 90Y-DOTATATE in metastatic treatment-refractory medullary thyroid cancer. Neuroendocrinology 2019; 108: 228
• 31 Lodewijk L, Willems SM, Dreijerink KMA. et al. The Theranostic Target Prostate-Specific Membrane Antigen Is Expressed in Medullary Thyroid Cancer. Hum Pathol 2018; 81: 245-254
• 32 Bychkov A, Vutrapongwatana U, Tepmongkol S. et al. PSMA Expression by Microvasculature of Thyroid Tumors – Potential Implications for PSMA Theranostics. Sci Rep 2017; 7 (01) 5202
• 33 Arora S, Prabhu M, Damle NA. et al. Prostate-specific Membrane Antigen Imaging in Recurrent Medullary Thyroid Cancer: A New Theranostic Tracer in the Offing?. Indian J Nucl Med 2018; 33 (03) 261-263
• 34 Arora S, Damle NA, Parida GK. et al. Recurrent Medullary Thyroid Carcinoma on 68Ga-Prostate-Specific Membrane Antigen PET/CT: Exploring New Theranostic Avenues. Clin Nucl Med 2018; 43 (05) 359-360
• 35 Ciappuccini R, Edet-Sansin A, Saguet-Rysanek V. et al. Thyroid Incidentaloma on 18F-fluorocholine PET/CT and 68Ga-PSMA PET/CT Revealing a Medullary Thyroid Carcinoma. Clin Nucl Med 2019; 44: 663-665
• 36 Schlumberger M, Bastholt L, Dralle H. et al. 2012 European Thyroid Association Guidelines for Metastatic Medullary Thyroid Cancer. Eur Thyroid J 2012; 1 (01) 5-14
• 37 Wells Jr, Asa SL, Dralle H. et al. Revised American Thyroid Association Guidelines for the Management of Medullary Thyroid Carcinoma. Thyroid 2015; 25 (06) 567-610
• 38 Beheshti M, Pocher S, Vali R. et al. The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: comparison with 18F-FDG PET-CT. Eur Radiol 2009; 19: 1425-1434
• 39 Kauhanen S, Schalin-Jantti C, Seppanen M. et al. Complementary roles of 18F-DOPA PET/CT and 18F-FDG PET/CT in medullary thyroid cancer. J Nucl Med 2011; 52: 1855-1863
• 40 Luster M, Karges W, Zeich K. et al. Clinical value of 18-fluorine-fluorodihydroxyphenylalanine positron emission tomography/computed tomography in the follow-up of medullary thyroid carcinoma. Thyroid 2010; 20: 527-533
• 41 Treglia G, Castaldi P, Villani MF. et al. Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging 2012; 39: 569-580
• 42 Verbeek HH, Plukker JT, Koopmans KP. et al. Clinical relevance of 18F- FDG PET and 18F-DOPA PET in recurrent medullary thyroid carcinoma. J Nucl Med 2012; 53: 1863-1871