Paraneoplastic ACTH secretion: Bronchial carcinoid overlooked by planar indium-111 pentetreotide scintigraphy and accurately localized by SPECT/CT acquisition

Pulmonary carcinoid tumors are the most frequent cause of Cushing's paraneoplastic syndrome and can be depicted by indium-111 pentetreotide scintigraphy. We report the case of a patient with a history of Cushing's paraneoplastic syndrome, who was referred for indium-111 pentetreotide scintigraphy. Planar acquisition was negative, but a SPECT/CT acquisition revealed a focus in the right hilar region, which was confirmed by contrast enhanced multidetector CT and led to thoracic surgery. Finally, a well-differentiated carcinoid tumor was found. This case highlights the need to perform SPECT acquisitions when planar acquisition is negative. © 2007 Lippincott Williams & Wilkins, Inc.