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CC BY 4.0 · World J Nucl Med
DOI: 10.1055/s-0045-1809341
Case Report

Pediatric Theranostics in a 13-Year-Old Female with Bronchial Carcinoid

Justine Trpezanovski 
1   Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia
,
Jonathan Karpelowsky
2   Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia
3   Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
,
Elizabeth Hesketh
4   Department of Paediatric Oncology & Haematology, John Hunter Children's Hospital, Newcastle, NSW, Australia
,
Kevin London 
1   Department of Nuclear Medicine, The Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, Sydney, NSW, Australia
5   Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
6   Alfred Nuclear Medicine and Ultrasound, Royal Prince Alfred Hospital Medical Centre, Newtown, Sydney, NSW, Australia
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Abstract

Pediatric bronchial carcinoid tumors are rare, accounting for a significant proportion of primary lung tumors in children but only a small fraction in adults. These tumors can present with symptoms such as cushing's syndrome due to ACTH secretion. Complete surgical resection typically results in favorable outcomes, with most tumors expressing somatostatin receptors, making them amenable to peptide receptor radionuclide therapy (PRRT) with (177Lu)Lu-DOTA-TATE (LuTATE).

This case report describes a 13-year-old female with a bronchial carcinoid tumor treated with multi-cycle high-dose LuTATE therapy in the neoadjuvant setting. Initial imaging and biopsy confirmed a grade G1 pulmonary carcinoid with intense somatostatin receptor expression. The patient underwent two cycles of LuTATE, with dosimetry calculations guiding dose escalation while maintaining safe kidney radiation exposure. Posttherapy scans showed a significant metabolic response of suspected nodal metastases and evidence of partial response of the primary tumor.

Two further LuTATE cycles were administered, with continued monitoring of kidney dosimetry to ensure safety. The treatment was well-tolerated, and the patient showed no significant complications. The case highlights the potential of LuTATE therapy to downstage tumors and reduce surgical morbidity in pediatric patients. Given the rarity of pediatric bronchial carcinoid tumors, phase III clinical trials are unlikely, but this report supports the inclusion of LuTATE in multidisciplinary treatment planning.

In conclusion, LuTATE therapy, guided by dosimetry calculations, offers a valid treatment option for pediatric bronchial carcinoid tumors, balancing efficacy, and safety in a challenging clinical scenario.

Keywords

bronchial - carcinoid - LuTATE - neuroendocrine - pediatrics

Ethical Approval

Ethical approval was provided by the Human Research Ethics Committee, The Children's Hospital at Westmead.


Authors' Contributions

K.L. and J.T. drafted the manuscript after reviewing the clinical details of the case. K.L. created the figures. J.T., J.K., and E.H. reviewed and edited the manuscript, provided clinical information about the patient, and contributed to the discussion points and revisions.




Publication History

Article published online:
26 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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