Expression of CXCR4 Receptors in Refractory Atypical Mediastinal Carcinoid

Venkata Subramanian Krishnaraju, Swayamjeet Satapathy, Ashwani Sood, Chandan Krushna Das, Debajyoti Chatterjee, Jaya Shukla, Bhagwant Rai Mittal
Clinical Nuclear Medicine 2020 July 8
Primary neuroendocrine tumor of the mediastinum is a relatively rare entity. In metastatic/inoperable disease, therapeutic options are limited to cytotoxic chemotherapy in poorly differentiated tumors and peptide receptor radionuclide therapy in case of well-differentiated tumors. We present the case of a 52-year-old man with mediastinal atypical carcinoid (grade II) neuroendocrine tumor showing mild somatostatin receptor expression and intense FDG avidity with progressive disease on chemotherapy. Chemokine receptor targeted PET/CT with CXCR4 (Ga-CXCR4) showed tracer avidity in tumor sites higher than the physiological sites, which may pave the way for CXCR4-targeted radionuclide therapy in this subgroup of patients.

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