Interesting images
Recurrent sinonasal meningioma: insights from somatostatin receptor imaging
Meningioma sinusal recurrente: perspectivas de las imágenes con receptores de somatostatina
Ahmed S. Abdlkadira, Rula Amarinb, Enrique Estrada-Lobatoc, Akram Al-Ibraheema,d,
Corresponding author
a Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, 11942, Jordan
b Department of Medicine, King Hussein Cancer Center (KHCC), Amman, 11942, Jordan
c Nuclear Medicine and Diagnostic Section, Division of Human Health, International Atomic Energy Agency (IAEA), Vienna, Austria
d Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan, Amman, 11942, Jordan
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Los cortes axiales PET/TC de la región craneal (B, C) mostraron una masa nasal derecha moderadamente hipermetabólica con un SUVmáx de 4,9 (flechas). Las proyecciones MIP y los cortes axiales de la PET/TC con [<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC de la cabeza (D-F) mostraron claramente una intensa expresión del radiotrazador en el interior de la tumoración nasal derecha (SUVmáx de 22,8). Las imágenes axial y sagital de la RM craneal en T1 (G, H) mostraron una masa única nasosinusal derecha hiperintensa. Los cortes axial y sagital de fusión PET/RM craneal (I, J) mostraron la localización precisa y muy activa dentro del meningioma nasal recidivado, con un diámetro máximo aproximado de 3,6.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.S. Abdlkadir, R. Amarin, E. Estrada-Lobato, A. Al-Ibraheem" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A.S." "apellidos" => "Abdlkadir" ] 1 => array:2 [ "nombre" => "R." 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The lower corners specify the theragnostic pairs.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Stefan Prado Wohlwend, Pilar Bello Arques" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Stefan" "apellidos" => "Prado Wohlwend" ] 1 => array:2 [ "nombre" => "Pilar" "apellidos" => "Bello Arques" ] 2 => array:1 [ "colaborador" => "on behalf of the SEMNIM Endocrinology Working Group" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000338?idApp=UINPBA00004N" "url" => "/22538089/0000004300000004/v3_202408070927/S2253808924000338/v3_202408070927/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "Recurrent sinonasal meningioma: insights from somatostatin receptor imaging" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ahmed S. Abdlkadir, Rula Amarin, Enrique Estrada-Lobato, Akram Al-Ibraheem" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ahmed S." "apellidos" => "Abdlkadir" "email" => array:1 [ 0 => "ahmedshukri92@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Rula" "apellidos" => "Amarin" "email" => array:1 [ 0 => "ramarin@khcc.jo" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "Enrique" "apellidos" => "Estrada-Lobato" "email" => array:1 [ 0 => "E.Estrada-Lobato@iaea.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:4 [ "nombre" => "Akram" "apellidos" => "Al-Ibraheem" "email" => array:2 [ 0 => "aibraheem@khcc.jo" 1 => "akramalibrahim@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, 11942, Jordan" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Medicine, King Hussein Cancer Center (KHCC), Amman, 11942, Jordan" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Nuclear Medicine and Diagnostic Section, Division of Human Health, International Atomic Energy Agency (IAEA), Vienna, Austria" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University of Jordan, Amman, 11942, Jordan" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Meningioma sinusal recurrente: perspectivas de las imágenes con receptores de somatostatina" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1609 "Ancho" => 3333 "Tamanyo" => 583680 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The MIP image (A) for [<span class="elsevierStyleSup">18</span>F]FDG PET/CT was unremarkable. Axial PET/CT views of the (B, C) head region revealed a mildly hypermetabolic right nasal mass lesion with an SUVmax of 4.9 (arrows). [<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC MIP and axial PET/CT head views (D-F) clearly depicted intense expression within the right nasal mass (SUVmax of 22.8). Axial, and sagittal T1 brain MRI (G, H) images exposed a single hyperintense right sinonasal mass. Axial and sagittal views of fused PET/MR (I, J) head views denoted precise and intense localization within the recurrent nasal meningioma, measuring about 3.6 in maximum dimension.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 63-year-old female with a history of two metachronous tumors, comorbid hypertension, and long-standing type 2 diabetes mellitus presented with a new-onset frontal headache. Notably, she underwent successful surgical resection of a right sinonasal meningioma 15 years ago. Additionally, five years ago, she underwent a left hemicolectomy for T3N0 stage IIA moderately differentiated adenocarcinoma. Following surgery, she received adjuvant capecitabine and oxaliplatin (XELOX) chemotherapy, which has resulted in sustained remission of colonic adenocarcinoma over the past five years.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Recent onset of frontal headache prompted a comprehensive clinical and biochemical evaluation with a full list of hematologic, renal, and hepatic profiles. All these findings were unremarkable, apart from an elevated creatinine level ranking at 1.8<span class="elsevierStyleHsp" style=""></span>mg/dL, exceeding the upper normal limit of 1.1<span class="elsevierStyleHsp" style=""></span>mg/dL. This prompted a broader investigative approach to elucidate potential underlying etiologies. As part of surveillance, [<span class="elsevierStyleSup">18</span>F]fluorodeoxyglucose ([<span class="elsevierStyleSup">18</span>F]FDG) positron emission tomography/computed tomography (PET/CT) was performed to exclude colonic adenocarcinoma recurrence (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The maximum intensity projection image (MIP) was unremarkable for colonic adenocarcinoma recurrence (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). However, axial PET/CT images of the head region revealed evidence of a mildly hypermetabolic right nasal mass lesion projecting along the right side of the nasal septum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, C). Such evidence is alarming for meningioma recurrence and mandated imaging correlation. For better evaluation [<span class="elsevierStyleSup">68</span>Ga]Ga-labeled 1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid-d-Phe1-Tyr3-octreotide ([<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC) PET/CT was conducted and revealed intense [<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC-avid right nasal mass suggesting nasal meningioma recurrence (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D–F), which was corroborated by concurrent magnetic resonance (MR) imaging (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>G, H). Retrospectively registered fused PET/MR images provided precise [<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC localization within the recurrent nasal meningioma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>I, J). In a multidisciplinary clinical discussion, it was decided to postpone further intervention for recurrent nasal meningioma until the current active renal disease was controlled.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Sinonasal meningioma represents an extremely rare subgroup of extracranial meningeal tumors.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> To date, little is known regarding the clinicopathologic aspects of meningioma at these anatomic sites. <a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Incidental finding of extracranial meningioma have been reported previously during the evaluation of unrelated entities. <a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In such cases, PET using [<span class="elsevierStyleSup">68</span>Ga]Ga-labeled somatostatin receptor (SSTR) ligands can provide valuable information due to the strong SSTR expression in these tumors. <a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> To our knowledge, this case is the first molecular imaging depiction of recurrent sinonasal meningioma recurrence, revealing the promising complementary role of SSTR imaging in this context.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">No funding source was used to support this work.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:2 [ "identificador" => "xack764515" "titulo" => "Acknowledgments" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-03-18" "fechaAceptado" => "2024-04-23" "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1609 "Ancho" => 3333 "Tamanyo" => 583680 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The MIP image (A) for [<span class="elsevierStyleSup">18</span>F]FDG PET/CT was unremarkable. Axial PET/CT views of the (B, C) head region revealed a mildly hypermetabolic right nasal mass lesion with an SUVmax of 4.9 (arrows). [<span class="elsevierStyleSup">68</span>Ga]Ga-DOTA-TOC MIP and axial PET/CT head views (D-F) clearly depicted intense expression within the right nasal mass (SUVmax of 22.8). Axial, and sagittal T1 brain MRI (G, H) images exposed a single hyperintense right sinonasal mass. Axial and sagittal views of fused PET/MR (I, J) head views denoted precise and intense localization within the recurrent nasal meningioma, measuring about 3.6 in maximum dimension.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary extracranial meningiomas of the sinonasal tract: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X.L. Goh" 1 => "J.R.T. Chee" 2 => "A.C. Tham" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Neurol Surg B Skull Base." 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